Beyond IUI, IVF and ICSI - New developments in - eshre 2013

Clinical Problem
Clinical Problem
Clinical Problem
Male infertility is a major reason for ART
• In a vast majority of infertile males sufficient numbers of spermatozoa are
present to achieve fertilization: it is sperm function that is compromised
• Normal male reproductive ffunction is not just about achieving ffertilization,
it is also about supporting normal embryonic development.
FSA
DNA damage in the male germ line
TUNEL (%)
90
80
70
60
50
40
30
20
10
TUNEL
0
Donors Patients
Mediaan
tail DNA
COMET
55
50
45
40
35
30
25
20
15
10
5
0
Donors Patients
Reproductive consequences of
DNA damage in the male germ line
•Impaired fertilization (Benchaib et al., 2003; Virro et al., 2004;
Aitken 2004)
•Disrupted preimplantation development (Sakkas et al.,
1998; Morris et al., 2002; Virro et al., 2004).
•Reduced pregnancy rates following natural or
assisted conception (Loft, 2003, Duran 2002,; Bungum et al.,
2004).
•Increased rates of abortion (Saleh et al., 2003; Carrell et al.,
2003; Zini and Sigman, 2009).
•Increased rates of disease in children and young
adults (Ji et al., 1997; Aitken and Krausz, 2001; Aitken, 2004).
Select spermatozoa possessing low levels of DNA damage
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