[Sperm DNA integrity as diagnosis and prognosis element of male fertility].

Recent progress in reproductive biology has improved comprehension physiology of the spermatozoa and on the fertilization mechanisms. This new knowledge has carried out the elaboration of tests on male fertility based on sperm genomic integrity. This review presents some of these techniques and brings a reflexion element on the application and use of sperm DNA integrity in the investigation of male fertility. The single cell gel electrophoresis (COMET assay), Sperm Chromatin Structure Assay (SCSA), In Situ Nick Translation (NT: Nick Translation) and Terminal Uridine Nick-End Labelling (TUNEL assay) are actually the most currently used techniques for the measure of sperm DNA integrity in research clinic. From a certain point of view, TUNEL assay, SCSA, COMET assay and NT assay are complementary. The TUNEL and COMET can measure single and double strand breaks of DNA, the SCSA can detect the abnormalities in the chromatin compaction and the NT assay can detect the single strand breaks of DNA. The exact origin of sperm DNA fragmentation is not established yet. However, several mechanisms have been proposed: defect in the chromatin compaction during spermiogenesis; reactive oxygen species production by immature spermatozoa; apoptosis during spermatogenesis. It becomes important to consider the possible consequences of the oocyte fertilization by a spermatozoon having a high degree of DNA fragmentation. The use in routine of some of these tests must however pass by a standardization of the inter laboratory protocols and obviously, by the establishment of both in vivo and in vitro discriminating threshold values in order for these tests to present a good predictive value for pregnancy outcome.