title: Negative effects of increased sperm DNA damage in relation to seminal oxidative stress in men with idiopathic and male factor infertility.
abstract: OBJECTIVE
  To examine the effects of increased sperm DNA damage in relation to seminal oxidative stress in men with idiopathic and male factor infertility. Prospective study.
  
  
  METHODS
  Infertility clinic at a tertiary care academic institution.
  
  
  METHODS
  Ninety-two infertile men with normal female partners. Sixteen fertile donors served as the control group.
  
  
  METHODS
  Standard semen analysis and assessment of levels of seminal oxidative stress. Assisted reproductive techniques in 33 of the 92 patients (IUI [n = 19], IVF [n = 10], and intracytoplasmic sperm injection [n = 4]).
  
  
  METHODS
  Sperm DNA damage by sperm chromatin structure assay. Results were expressed as DNA fragmentation index.
  
  
  RESULTS
  Patients were classified as having either idiopathic (n = 23) or male factor infertility (n = 69). Patients with idiopathic and male factor infertility had significantly higher DNA fragmentation index and oxidative stress compared with the case of fertile donors. A clinical pregnancy was achieved in 9 (27%) of 33 patients with assisted reproductive techniques. Significantly higher DNA fragmentation index and oxidative stress were found in men who failed to initiate a pregnancy after assisted reproductive techniques (n = 24), compared with the cases of those who succeeded and of the fertile donors. DNA fragmentation index was correlated positively with oxidative stress (r = 0.27), and negatively with fertilization (r = -0.70) and embryo quality (r = -0.70).
  
  
  CONCLUSIONS
  Sperm DNA damage is significantly increased in men with idiopathic and male factor infertility and in men who failed to initiate a pregnancy after assisted reproductive techniques. Such an increase may be related to high levels of seminal oxidative stress.
authors.affiliation: Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Urological Institute, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
authors.forename: Ramadan A
authors.initials: RA
authors.lastname: Saleh
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
authors.forename: Essam A
authors.initials: EA
authors.lastname: Nada
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: El-Tonsy
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Sharma
authors.forename: Andrew
authors.initials: A
authors.lastname: Meyer
authors.forename: David R
authors.initials: DR
authors.lastname: Nelson
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Thomas
mesh_terms: D000328:Adult; D002843:Chromatin / Q000648:ultrastructure; D004249:DNA Damage; D006801:Humans; D007248:Infertility, Male / Q000235:genetics* / Q000378:metabolism*; D008297:Male; D018384:Oxidative Stress; D011446:Prospective Studies; D012661:Semen / Q000378:metabolism*; D013076:Sperm Count; D013094:Spermatozoa / Q000648:ultrastructure*
chemical_list: D002843:Chromatin