ICSI Outcome after Assessment of Sperm DNA Integrity for Diagnosis of Fertility Potential

Rationale: Conventional semen analysis parameters are not sufficient to evaluate male infertility and fertility potential. Now markers of sperm DNA integrity may be better measures of male fertility potential than conventional measures. Sperm DNA damage tests are now available, which has been driven largely by the growing use of assisted reproductive technologies and awareness that the integrity of the male genome plays an important role in IVF. Objective: Our study aimed to evaluate sperm DNA integrity for diagnosis of fertility potential in Egyptian infertile patients with oligo-, astheno- and teratozoospermia, prior to Intra cytoplasmic sperm injection (ICSI), aiming to predict the fertilizing potential, using histochemical technique. Subject and Methods: A total number of 40 men were included in this study, 10 normal fertile men and 30 infertile men with no recognized cause of female infertility. Patients were classified according to the data obtained from routine semen analysis into oligo-, astheno- and teratozoospermia patients. Quantitative measurements of sperm carried out using the image analyzing system. Semen smears were prepared for every patient, the first smear stained with Haematoxylin and Eosin (H/E) for morphological structure, while the second smear stained with methyl green pyronin for localization of nucleic acid (DNA). The obtained histochemical reaction images were calibrated to obtain the optical densities of such reactions by the image analyzing system. Statistical analysis: Student t-test was adopted to compare the obtained optical densities by image analyzing system from normal, oligo-, astheno- and teratozoospermia groups. Results: Head length showed extreme values in cases of teratozoospermia, also tail length was dramatically longer in control group and shorter in all infertile groups. Methyl green pyronin revealed significant decrease of DNA values in all infertile groups, and it is a good indicator to fertility. However, there are some exceptions as some infertile cases may show either normal or higher values. Conclusion: Our data revealed that the assessment of sperm DNA integrity for diagnosis of fertility potential is very important step during the era of ART, especially when using histochemical technique. Also, the dependence on only semen analysis with its routine parameters is not sufficient for infertility evaluation