Infertility is faced by nearly 15% of the global population and a large percentage is due to the male factor. With the introduction of IVF and the ICSI (intracytoplasmic sperm injection), many hurdles have been crossed, offering a solution to the dream of many infertile couples. The quality and development of the embryo is crucial and, for this, sperm quality parameters are essential.
DNA damage in sperm can reduce the rate of successful ART. Studies have shown that SDF (sperm DNA fragmentation) has sometimes diminished embryo development and increased miscarriage rates. Hence, the importance of good quality sperm cannot be exaggerated.
TESE (testicular sperm extraction) is a type of sperm retrieval. It involves taking sperm directly from the testicular tissue of a man’s reproductive system. There are certain advantages to using testicular sperm over epididymis sperm.
- If a man cannot release healthy sperm naturally, this procedure could help.
- Due to oxidative stress, sperm from the epididymis can have more DNA damage.
- DFI tests (DNA fragmentation index) has been found to be lower in testicular sperm than in sperm produced in the epididymal transit.
- DFI has been shown to be much lower in sperm samples from the testes when compared with ejaculated sperm samples from the same person.
Hence, in many cases of non-azoospermic clients who have higher levels of DNA damage and have failed implantation, testicular sperm is being used for ICSI procedures. Studies have shown a marked increase in clinical pregnancy and live birth rates using T-ICSI (testicular sperm) instead of Ej-ICSI (ejaculated sperm). There has also been a decrease in miscarriages.
However, the use of testicular sperm is also debatable since it involves surgery which causes risks. There are various methods of testicular sperm retrieval – TESA (testicular sperm aspiration), TESE (testicular sperm extraction) or microTESE (microscopic testicular sperm extraction). Any surgical procedure is open to complications. In this case, some of them are testicular hematoma, infection, testicular loss and anesthetic problems. There is also a slight possibility of increased aneuploidy (abnormal number of chromosomes) rate in testicular sperm which can cause a negative pregnancy outcome. Also, there is no standardised test to check the quality of sperm extracted from the testes owing to the low number of sperm obtained.
No matter whether testicular or ejaculated sperm is used, the quality of DNA of the sperm is really important. That is why the testing for SDF (sperm DNA fragmentation) for ejaculated sperm is essential for both the fertility specialist and couple to decide on the best treatment possible.
At Andrology Center, we specialise in conducting comprehensive semen analysis tests. In addition, we provide advanced testing for sperm DNA fragmentation index (DFI) to identify any potential sperm DNA damage and determine its extent. We take pride in being the exclusive authorised laboratory in India that offers the highly accurate SCSA (sperm chromatin structure assay) test, utilising state-of-the-art equipment. With our cutting-edge technology and expertise, we ensure reliable and authentic results for every client.