REVIEW  HOT TOPICS IN REPRODUCTIVE BIOLOGY: THE STATE OF THE ART OF ART FOR REPRODUCTIVE PROFESSIONALS Free access

Panminerva Medica 2023 June;65(2):148-58

DOI: 10.23736/S0031-0808.23.04870-X

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

How to select healthy sperm for intracytoplasmic sperm injection in samples with high sperm DNA fragmentation?

Nicolás GARRIDO ^{1, 2}, Murat GÜL ^{1, 3}, Sunil JINDAL ^{1, 4}, Paraskevi VOGIATZI ^{1, 5}, Ramadan SALEH ^{1, 6}, Damayanthi DURAIRAJANAYAGAM ^{1, 7}, Lodovico PARMEGIANI ⁸, Florence BOITRELLE ^{1, 9, 10}, Giovanni M. COLPI ^{1, 11}, Ashok AGARWAL ^{1, 12} ✉

¹ Global Andrology Forum, Moreland Hills, OH, USA; ² IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; ³ School of Medicine, Department of Urology, Selcuk University, Konya, Türkiye; ⁴ Department of Andrology and Reproductive Medicine, Jindal Hospital and Fertility Center, Meerut, India; ⁵ Andromed Health and Reproduction, Fertility and Reproductive Health Diagnostic Center, Athens, Greece; ⁶ Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt; ⁷ Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia; ⁸ Andrology and IVF Center NextFertility Procrea, Lugano, Switzerland; ⁹ Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France; ¹⁰ Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France; ¹¹ Next Fertility Procrea, Lugano, Switzerland; ¹² American Center for Reproductive Medicine, Cleveland, OH, USA

The body of evidence supports the negative impact of increased sperm DNA fragmentation (SDF) on natural fertility as well as assisted reproduction conditions. High SDF has been correlated with low pregnancy and delivery rates following intrauterine insemination. Also, high SDF is accused of reducing the rates of fertilization, implantation, pregnancy, and live birth following in-vitro fertilization (IVF). Despite no impact of high SDF on fertilization or pregnancy rates following intracytoplasmic sperm injection (ICSI), it has been correlated with poor embryo quality and a higher risk of miscarriage. Several methods have been introduced to help select sperm with the best DNA quality to be used in assisted reproductive technology procedures. These include magnetic-activated cell sorting, intracytoplasmic morphologically selected sperm injection, physiologic ICSI, and microfluidic sperm sorters, among others. This article aimed to discuss the impact of high SDF in infertile men on the reproductive outcome of couples undergoing IVF/ICSI. Additionally, this review highlights the principles, advantages, and limitations of different techniques that are currently used for the selection of sperm with intact DNA to be utilized for ICSI.

KEY WORDS: Sperm injections, intracytoplasmic; Infertility, male; DNA fragmentation