Conti Donata, Calamai Costanza, Muratori Monica
Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy.
J Clin Med. 2024 Sep 7;13(17):5309. doi: 10.3390/jcm13175309.
Sperm DNA fragmentation (sDF) is a DNA damage able to predict natural conception. Thus, many laboratories added tests for the detection of sDF as an adjunct to routine semen analysis with specific indications. However, some points related to sDF are still open. The available tests are very different each from other, and a direct comparison, in terms of the prediction of reproductive outcomes, is mandatory. The proposed mechanisms responsible for sDF generation have not yielded treatments for men with high levels of sDF that have gained the general consent in clinical practice, thus requiring further research. Another relevant point is the biological meaning to attribute to sDF and, thus, what we can expect from tests detecting sDF for the diagnosis of male infertility. SDF can represent the "tip of iceberg" of a more extended and undetected sperm abnormality somehow impacting upon reproduction. Investigating the nature of such a sperm abnormality might provide novel insights into the link between sDF and reproduction. Finally, several studies reported an impact of native sDF on assisted reproduction technique outcomes. However, to fertilise the oocyte, selected spermatozoa are used where sDF, if present, associates with highly motile spermatozoa, which is the opposite situation to native semen, where most sDF associates with non-viable spermatozoa. Studies comparing the impact of sDF, as assessed in both native and selected spermatozoa, are needed.
精子DNA碎片化（sDF）是一种能够预测自然受孕的DNA损伤。因此，许多实验室增加了sDF检测试验，作为常规精液分析的辅助手段，并给出了具体适应症。然而，与sDF相关的一些问题仍未解决。现有的检测方法彼此差异很大，在预测生殖结局方面进行直接比较是很有必要的。导致sDF产生的假定机制尚未产生在临床实践中获得普遍认可的针对sDF水平高的男性的治疗方法，因此需要进一步研究。另一个相关问题是赋予sDF的生物学意义，以及由此我们可以从检测sDF的试验中期待什么来诊断男性不育症。sDF可能代表了某种对生殖有影响的更广泛且未被检测到的精子异常的“冰山一角”。研究这种精子异常的本质可能会为sDF与生殖之间的联系提供新的见解。最后，几项研究报告了天然sDF对辅助生殖技术结局的影响。然而，为了使卵子受精，使用的是经过筛选的精子，在这种情况下，如果存在sDF，它会与高活力精子相关联，这与天然精液的情况相反，在天然精液中，大多数sDF与无活力精子相关联。需要进行研究来比较在天然精子和筛选精子中评估的sDF的影响。
