title: Fragmentation of sperm DNA using the TUNEL method.
abstract: OBJECTIVE
  To establish the validity of the TUNEL assay in determining sperm DNA fragmentation, the relationship between the degree of fragmentation and the seminal parameters and the sample needed to conduct the test.
  
  
  METHODS
  We used semen samples from healthy fertile men (n=33), patients who consulted for infertility with a prescription for the TUNEL assay (n=77) and patients with intracytoplasmic sperm injection failure (n=20), analyzed according to the 2010 WHO. The TUNEL/propidium iodide test was performed by flow cytometry, on baseline and post-swim-up samples.
  
  
  RESULTS
  The cutoff value for the TUNEL assay (ROC curves) was 26%, with a sensitivity and specificity of 85% and 89%, respectively. The pre-swim-up and post-swim-up medians of the results from the TUNEL assay showed no significant differences (17.0% vs. 12.9%, respectively). However, 39.1% of the samples showed a difference greater than 15 in absolute value between the results of the baseline and post-swim-up TUNEL assays. The linear correlation study of the morphology, mobility and vitality using the post-swim-up TUNEL assay showed a greater correlation than preselection, with significant results (r: -0.394, P<.0001; r: -0.461, P<.0001; r: -0.526, P<.0001).
  
  
  CONCLUSIONS
  The TUNEL assay is a valid test for clinical use. DNA fragmentation is a factor independent from traditional semen tests. We found a greater susceptibility to damage generated in the laboratory procedures in the samples with lower quality. The sample of choice for evaluating DNA fragmentation will depend on whether the clinician is treating a natural or assisted fertilization.
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: P H
authors.initials: PH
authors.lastname: Chenlo
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: S M
authors.initials: SM
authors.lastname: Curi
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: M N
authors.initials: MN
authors.lastname: Pugliese
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: J I
authors.initials: JI
authors.lastname: Ariagno
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Sardi-Segovia
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: M J
authors.initials: MJ
authors.lastname: Furlan
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: H E
authors.initials: HE
authors.lastname: Repetto
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: E
authors.initials: E
authors.lastname: Zeitler
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Hospital de Clínicas José de San Martín, Buenos Aires, Argentina. Electronic address: gmendeluk@ffyb.uba.ar.
authors.forename: G R
authors.initials: GR
authors.lastname: Mendeluk
mesh_terms: D000328:Adult; D004247:DNA; D006801:Humans; D020287:In Situ Nick-End Labeling; D007248:Infertility, Male / Q000175:diagnosis* / Q000235:genetics*; D008297:Male; D015203:Reproducibility of Results; D013094:Spermatozoa
chemical_list: D004247:DNA
keywords: Fragmentación del núcleo espermático; Parámetros espermáticos; Sperm nucleus fragmentation; Sperm parameters; Susceptibilidad al daño en el laboratorio; Susceptibility to damage in the laboratory; Swim up; TUNEL; Test validity; Validez de la prueba