AB28. Management of male factor infertility: present on the assisted reproductive technology

Abstract: Infertility is a common yet complex problem affecting approximately 10-15% of couples attempting to conceive a baby. Especially, 40-50% of these factors are known as male-related disorders. Unlike female infertility, the cause of which is often easily identified, diagnosing male factors can be difficult. Male infertility is due to low sperm production, abnormal sperm function or blockages of sperm transport.

Classical semen analysis in laboratory, which include sperm concentration, motility and morphology gives an approximate evaluation of the functional competence of spermatozoa, but does not always reflect the quality of sperm DNA. The fertilizing potential of sperm depends not only on the functional competence of spermatozoa but also on sperm DNA integrity. The most commonly used techniques to assess sperm DNA integrity are the TUNEL assay, Comet assay, SCSA assay and hallo sperm assay. Recent studies have highlighted the significance of sperm DNA integrity as an important factor which affects functional competence of the sperm. Sperm DNA damage has been closely associated with numerous indicators of reproductive health including fertilization, embryo quality, implantation, spontaneous abortion, congenital malformations.

To overcome male infertility, there are variety of surgical and non-surgical urological procedures and medical-pharmacological interventions, and advanced assisted reproductive technologies (ART). Among the surgically retrieved methods, there are TESE, TFNA, PESA and MESA that is used with ICSI.

The ART, augmented with ICSI in moderate to serve cases, efficiently treat a variety of male infertility disorders by constituting validated and successfully treatment methods. Also, this technique is employed because the limited numbers and functional capacity of motile sperm that can be obtained. Especially, there are technologies such as IMSI and PICSI that are used to select healthy sperms.

Keywords: Male factor infertility; DNA integrity; TUNEL assay