Each man delivered between one and four ejaculates, which were either used in the clinic diagnostic work or in the treatment of the couple. The coefficient of variation of SCSA variables within a man were much lower than for the classical measures Schrader et al. This was a prospective study of presumably fertile couples wishing to achieve pregnancy and who were discontinuing contraception. The WHO parameters address only few aspects of sperm quality and function, and during the last decades, several other sperm function tests have been suggested and used, including vital staining, biochemical analysis of semen, hypo-osmotic swelling test, antisperm antibody test, sperm penetration assay, hemizona assay, reactive oxygen species ROS tests and computer-assisted sperm analysis. The highest correlation was found between HDS and the morphology categories, sperm head shape and acrosome defect, which may reflect that the cells in the HDS region could be larger and immature sperm with increased native DNA-binding sites. There was a high degree of repeatability, i. This reference sample was not characterized as fertile or infertile, but was used only for quality control.
Moreover, data from a so far unpublished study support this statement. All men with an abnormal semen analysis are candidates for this test as well as men with normal semen analyses who have failed IVF for unexplained reasons. Diagnosis of male infertility has mainly been based on the traditional semen parameter's concentration, motility and morphology. Spermatazoa with high DNA fragmentation may fertilize an egg and embryo development stops before implantation or may even initiate a pregnancy, but there is a significantly higher likelihood that it will result in miscarriage.
The sperm are then labeled with a special orange colored dye that only attaches to the ends of broken DNA within the sperm cell. Trials have shown that the fertilization rates of men containing low numbers of sperm chromatin damage are only slightly higher to those who have quite high sperm chromatin damage. Flow chart for a possible use of SCSA in diagnosis and treatment of infertility. Moreover, data from a so far unpublished study support this statement. Apart from being subjected to a very limited intralaboratory variation, 50 however, the SCSA analysis has shown to be very robust to variation between laboratories.
J Assist Reprod Genet. It has, however, become apparent that none of these parameters are reliable markers for evaluation of the fertility potential of a couple. The applicability of the flow cytometric sperm chromatin structure assay in epidemiological studies. Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa. However, our recent data have demonstrated that, despite this apparent intraindividual variation, a single SCSA analysis performed on a random day in relation to the infertility work-up or to the conception is a strong predictor of infertility. In summary, these two studies, as well as previous studies, provide a solid rationale for andrology clinics to measure SCSA in all or selected semen samples before counselling patients on fertility issues, especially expensive assisted reproduction procedures.