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INTRODUCTIONUp to 15% of couples suffer from infertility worldwide, with male factors contributing to 50% of these cases.1–3 Phenotypes of reduced sperm motility, low sperm concentration, and morphological abnormalities are solely and/or jointly characterized in infertile males.2 However, an imperfect association between the basic semen parameter values, such as sperm concentration, motility, and morphology, and clinically assisted reproductive technology (ART) outcomes has been reported. This poses a challenge to diagnosing male fertility potential and predicting the success rate of ARTs.4 To overcome the limitations of basic semen examinations, the World Health Organization (WHO) suggested that sperm DNA fragmentation (SDF) be used as an extended parameter in their 6th edition of the Manuel for Human Semen Analysis guidelines (2021). SDF is associated with male infertility and significantly correlated to ART's success rate.5–9Four main methods have been used to assess the integrity of sperm DNA in clinical/research laboratories: terminal deoxynucleotidyl transferase‐mediated nick end‐labeling (TUNEL), sperm chromatin structure assay (SCSA), single‐cell gel electrophoresis (Comet) assay, and a sperm chromatin dispersion (SCD) test.10,11 The results derived from TUNEL and SCSA show high sensitivity and reliability; however, these two assays highly depend on the instruments available, including fluorescent microscopy and flow cytometer, the training
Andrology – Wiley
Published: Mar 3, 2023
Keywords: artificial intelligence; computer‐assisted semen analysis; male infertility; semen quality; sperm DNA breaks
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