title: Sperm chromatin structure is associated with the quality of spermatogenesis in infertile patients.
abstract: OBJECTIVE
  To establish the diagnostic value of sperm chromatin structure assessment for the evaluation of male factor infertility, in addition to conventional andrological workup.
  
  
  METHODS
  Cross-sectional controlled study.
  
  
  METHODS
  A tertiary referral andrology clinic.
  
  
  METHODS
  Two hundred seventy-nine male partners of infertile couples.
  
  
  METHODS
  None.
  
  
  METHODS
  The DNA fragmentation index (DFI) determined by the sperm chromatin structure assay (SCSA), semen parameters, serum levels of reproductive hormones, and World Health Organization (WHO) classification of male factor subfertility.
  
  
  RESULTS
  In all patient categories, except those including patients with hypogonadotrophic hypogonadism, sperm antibodies, or normospermia, DFI was significantly higher compared with in proven fertile controls. After classification of the quality of spermatogenesis based on mean testicular volume (<10 ml vs. >15 ml), follicle stimulating hormone (FSH; > 10 U/L vs. <5 U/L), and inhibin-B (<100 nmol/L vs. >150 nmol/L), the DFI was significantly higher in patients with poor spermatogenesis (35.9%) than in patients with normal spermatogenesis (25.9%). In a multiple regression analysis, the teratozoospermia index, sperm vitality, and FSH were significant determinants of the DFI level. Male age was associated with DFI, but leukocytospermia, body mass index, and smoking were not confounders of DFI.
  
  
  CONCLUSIONS
  Impaired spermatogenesis, irrespective of the WHO classification of male factor subfertility, is generally associated with an increase of sperm DNA damage.
authors.affiliation: Andrology Unit of the Department of Urology, Erasmus MC Rotterdam, Rotterdam, the Netherlands. m.smit.3@erasmusmc.nl
authors.forename: Marij
authors.initials: M
authors.lastname: Smit
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Romijn
authors.forename: Mark F
authors.initials: MF
authors.lastname: Wildhagen
authors.forename: Robertus F A
authors.initials: RF
authors.lastname: Weber
authors.forename: Gert R
authors.initials: GR
authors.lastname: Dohle
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002843:Chromatin / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D053938:DNA Fragmentation; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D007265:Inhibins / Q000097:blood; D008297:Male; D012044:Regression Analysis; D013091:Spermatogenesis / Q000502:physiology*; D013094:Spermatozoa / Q000000981:diagnostic imaging*; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography; D014944:World Health Organization
chemical_list: D002843:Chromatin; D013739:Testosterone; D007265:Inhibins; D005640:Follicle Stimulating Hormone