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      Paternal age: Negative impact on sperm genome decays and IVF outcomes after 40 years

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          Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios

          Sperm DNA fragmentation (SDF) has been generally acknowledged as a valuable tool for male fertility evaluation. While its detrimental implications on sperm function were extensively investigated, little is known about the actual indications for performing SDF analysis. This review delivers practice based recommendations on commonly encountered scenarios in the clinic. An illustrative description of the different SDF measurement techniques is presented. SDF testing is recommended in patients with clinical varicocele and borderline to normal semen parameters as it can better select varicocelectomy candidates. High SDF is also linked with recurrent spontaneous abortion (RSA) and can influence outcomes of different assisted reproductive techniques. Several studies have shown some benefit in using testicular sperm rather than ejaculated sperm in men with high SDF, oligozoospermia or recurrent in vitro fertilization (IVF) failure. Infertile men with evidence of exposure to pollutants can benefit from sperm DNA testing as it can help reinforce the importance of lifestyle modification (e.g., cessation of cigarette smoking, antioxidant therapy), predict fertility and monitor the patient’s response to intervention.
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            Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome.

            The sperm chromatin structure assay (SCSA) has been suggested as a predictor of fertility in vivo as well as in vitro. The available data however, have been based on limited numbers of treatments. We aimed to define the clinical role of SCSA in assisted reproduction. A total of 998 cycles [387 intrauterine insemination (IUI), 388 IVF and 223 ICSI] from 637 couples were included. SCSA results were expressed as DNA fragmentation index (DFI) and high DNA stainable (HDS) cell fractions. Outcome parameters were biochemical pregnancy (BP), clinical pregnancy (CP) and delivery (D). For IUI, the odds ratios (ORs) for BP, CP and D were significantly lower for couples with DFI >30% as compared with those with DFI 30% group, the results of ICSI were significantly better than those of IVF. DFI can be used as an independent predictor of fertility in couples undergoing IUI. As a result, we propose that all infertile men should be tested with SCSA as a supplement to the standard semen analysis. When DFI exceeds 30%, ICSI should be the method of choice.
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              Sperm DNA damage is associated with an increased risk of pregnancy loss after IVF and ICSI: systematic review and meta-analysis.

              Sperm DNA damage is common amongst infertile men and may adversely impact natural reproduction, IUI-assisted reproduction and to a lesser degree IVF pregnancy. The aim of this study was to examine the influence of sperm DNA damage on the risk of spontaneous pregnancy loss after IVF and ICSI. We conducted a systematic review and meta-analysis of studies on sperm DNA damage and pregnancy loss after an IVF and/or ICSI pregnancy. Two by two tables were constructed and odds ratios (ORs) were derived from 11 estimates of pregnancy loss (five IVF and six ICSI studies from seven reports). These 11 studies involved 1549 cycles of treatment (808 IVF and 741 ICSI cycles) with 640 pregnancies (345 IVF and 295 ICSI) and 122 pregnancy losses. The combined OR of 2.48 (95% CI 1.52, 4.04, P < 0.0001) indicates that sperm DNA damage is predictive of pregnancy loss after IVF and ICSI. In conclusion, sperm DNA damage is associated with a significantly increased risk of pregnancy loss after IVF and ICSI. These data provide a clinical indication for the evaluation of sperm DNA damage prior to IVF or ICSI and a rationale for further investigating the association between sperm DNA damage and pregnancy loss.
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                Author and article information

                Journal
                Molecular Reproduction and Development
                Mol Reprod Dev
                Wiley
                1040452X
                March 2018
                March 2018
                March 01 2018
                : 85
                : 3
                : 271-280
                Affiliations
                [1 ]Faculty of Sciences; Biochemistry and Immunology Laboratory; Mohammed V University; Rabat Morocco
                [2 ]Labomac IVF centers and clinical laboratory medicine; Casablanca Morocco
                [3 ]IVF center IRIFIV Clinique des Iris; Place de nid aux Iris; Casablanca Morocco
                [4 ]Université Montpellier; UFR de Médecine; Institute for Regenerative Medicine and Biotherapy; INSERM U1183; CHRU Montpellier; Hôpital Saint-Eloi; Montpellier France
                [5 ]Reproductive Biology and Medical Cytogenetics Laboratory; Regional University Hospital & School of Medicine; Picardie University Jules Verne; Amiens France
                [6 ]Reproductive Medicine, Developmental and Reproductive Biology; Regional University Hospital & School of Medicine and PERITOX Laboratory; Picardie University Jules Verne; Amiens France
                [7 ]Anfa Fertility Center; Privante Clinic of Human Reproduction and Endoscopic surgery; Casablanca Morocco
                Article
                10.1002/mrd.22963
                © 2018

                http://doi.wiley.com/10.1002/tdm_license_1.1

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