Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient’s fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA) were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment). TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele

Role of exogenous antioxidants on the performance and function of pig sperm after preservation in liquid and frozen states: A systematic review

In situations where an excessive generation of reactive oxygen species overwhelms antioxidant capacity, a harmful effect on sperm function is exerted. Antioxidants are molecules capable of minimizing this detrimental effect, which is important in pig sperm due to the high content of polyunsaturated fatty acids in their plasma membrane. The present systematic review aims at evaluating whether supplementing semen extenders (for liquid storage at 17 °C) or freezing and/or thawing media (for cryopreservation) with antioxidants influences sperm quality and functionality parameters, and in vitro/in vivo fertility outcomes. We defined inclusion and exclusion criteria in a PICOS table according to PRISMA guidelines, and conducted a literature search through MEDLINE-PubMed in November 2020. After systematic selection, 75 studies were included: 47 focused on cryopreservation and 28 on liquid storage at 17 °C. More than 70% of the studies included in this review showed that adding semen extenders for liquid storage and/or freezing/thawing media for cryopreservation with antioxidants enhances sperm quality and functionality parameters. In addition, this supplementation improves in vivo/in vitro fertility outcomes, supporting the hypothesis that the beneficial effect observed upon sperm quality has a positive impact on reproduction outcomes

An Update on Clinical and Surgical Interventions to Reduce Sperm DNA Fragmentation in Infertile Men

Sperm chromatin integrity is essential for normal embryo development and pregnancy outcome. Sperm DNA fragmentation (SDF) testing constitutes a diagnostic tool to measure the proportion of sperm with damaged chromatin in the ejaculate. SDF is associated with potentially treatable conditions, including varicocele, male accessory gland infections, inadequate lifestyle, and gonadotoxin exposure, thus prompting their treatment as a means of improving sperm DNA quality and the reproductive outcomes