Tarih:Feb 6, 2017 Yazar:Ender Yalcinkaya Kalyan
Today, routine semen analysis is based on conventional parameters. These parameters are sperm concentration, motility an morphological analysis. The use of sperm DNA fragmentation has reached a considerable ratio and almost integrated into routine semen analysis. Well then, what is sperm DNA fragmentation and what does it show us?
DNA fragmentation corresponds to the defects in genetic material DNA due to toxic agents exposed (cigarette, alcohol, chemical substances), temperature fluctuations and infections. Since DNA damage cannot be detected by naked eye during microscopic semen evaluation, it requires analysis by special tests. In order to do this test, it is necessary to have sexual abstinence for 2-7 days as in semen analysis. Testing DNA damage is especially meaningful in men who admitted with a semen analysis having normal sperm count and motility. While these parameters are normal, this test may present an answer to the questions such as "why there is no fertilization?" or "why no pregnancy occurs?".
Cut-off value that is used in sperm DNA fragmentation tests is around 25-30%. This means that if 30 out of 100 spermatozoa show DNA fragmentation while sperm concentration and motility are within normal range, we can offer using special methods that may provide detailed sperm selection (for ex: spermchip, IMSI, etc..) or testicular sperm extraction (TESE) especially to the patients with previous failed IVF attempts. At the same time, sperm DNA fragmentation test can be used to make a choice between insemination and in vitro fertilization treatment. For a patient having a high ratio of DNA fragmentation, in vitro fertilization can be recommended instead of intrauterine insemination. Moreover, patients with a high sperm DNA fragmentation may be offered to use multivitamins consisting of antioxidants. However, there is still need to perform extensive studies in order to prove whether these medications have a positive effect on sperm quality.
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