Title: Redefining the relationship between sperm DNA fragmentation as measured by the sperm chromatin structure assay (SCSA®) and outcomes of assisted reproductive techniques (ART)
Abstract: OBJECTIVE:The human oocyte is surrounded by the cumulus oophorous of which hyaluronan (a high molecular weight glycosaminoglycan) is the major component.Hyaluronan may play a role during fertilization by selection of functionally competent sperm.Mature, motile sperm bind with hyaluronan through specific receptors.Sperm maturity, morphology and chromatin integrity have been demonstrated to be correlated with spermhyaluronan binding.A commercially available hyaluronan binding assay (HBA™, Biocoat, Inc, Ft.Washington, PA) is currently available.Sperm morphology and in vitro fertilization (IVF) rates are inter-related.The relationship between sperm fertilization and the HBA is not known.Therefore, the study objective was to determine this relationship.DESIGN: Prospective comparison of HBA scores with conventional IVF results.MATERIALS AND METHODS: Sperm HBA scores were determined in the male partners of patients at the time of receiving infertility treatment via conventional in vitro fertilization-embryo transfer.Sperm were isolated from the seminal fluid by silica particle suspension-washing (Promotor, CERES Fertility, San Diego, CA) and incubated in Sperm Wash Medium (InVitroCare, San Diego, CA, USA) at 37 o C, to induce capacitation.HBA (provided, in kind, by Mid-Atlantic Diagnostics, Inc., Marlton, NJ) was performed following the manufacturers' instructions: briefly, an aliquot (10L) of semen is deposited on the HBA slide and incubated 10 minutes, and the total number of motile bound and unbound sperm recorded.Data were subjected to linear regression analysis and student t-test.RESULTS: A total of 62 semen specimens were analyzed as described above.The mean (ϮSEM) IVF rate was 0.662 (Ϯ0.03).The mean HBA score (ϮSEM) was 0.722 (Ϯ0.03).Linear regression analysis revealed a significant and positive relationship [R 2 ϭ0.084;Fϭ5.518; Pϭ0.022] between IVF and HBA results.There was a significant (PϽ0.001)difference in HBA scores between normal (Ͼ70%) IVF rates (HBA scoreϭ0.784)and abnormal (Ͻ70%) IVF rates (HBA scoreϭ0.619).CONCLUSION: Hyaluronan may play a significant role during fertilization by selection of functionally competent sperm.In the present study we found a significant relationship between the HBA and IVF.As HBA increases the respective sperm's HBA result also increases.Additional studies are warranted to determine the impact HBA has upon male fertility diagnostics and therapy.