Background: Male infertility is approaching an epidemic proportion. Almost 50% of all cases of infertility may be associated with a male factor. The diagnostic usefulness of sperm DNA integrity is now accessible as an additional tool to Seminal Fluid Analysis. Objective: To assess sperm DNA fragmentation index (SDFI) in male infertility and its relationship with obesity, alcohol consumption and cigarette smoking among infertile Nigerians. Patients and Methods: Patients who presented for infertility at three health facilities of Nordica Fertility Center in Lagos, Asaba and Abuja cities in Nigeria. STATA 13 was used for student’s t-test to compare the means of continuous variables among smokers and non-smokers and among alcohol consumers and non-consumers. Linear regression analysis was employed to assess the correlation between SDFI as dependent variable and some independent variables. Results: There was no significant difference in the SDFI of men aged <40 years compared to older men. There was also no significant difference in the proportion of men with SDFI of <25% and of ≥25% regardless of their age group. The mean SDFI of men with normal BMI (30.8%) was significantly lower (t = −1.80, P-value = 0.04) than that of obese men (30.2%). Obese men were 2.12 times as likely to have SDFI ≥25% compared to normal weight men (χ2-2.16, P-value = 0.14, OR = 2.12, 95% CI: 0.77, 5.80). Mean SDFI of men who consume alcohol (37.1%) was significantly higher (t = −1.97, P-value = 0.03) than that of those who did not consume alcohol. Although Pearson’s correlation matrix (r) indicated that sperm DNA fragmentation index was positively correlated with history of infertility (r = 0.01), groin surgery (r = 0.04), mumps (r = 0.04) and sexually transmitted illness (r = 0.04), however the degree of correlation was not significant (P-value ≥ 0.5) in each case. Conclusion: This is the first report in Black Africa that describes a correlation between sperm DNA
References
[1]
Gurunath, S., Pandian, Z., Anderson, R.A. and Bhattacharya, S. (2001) Defining Infertility—As Systematic Review of Prevalence Studies. Human Reproduction Update, 17, 575-588. https://doi.org/10.1093/humupd/dmr015
[2]
World Health Organization (1999) Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucucs Interaction. 4th Edition, Cambridge University Press, Cambridge.
[3]
World Health Organization (2000) WHO Manual for the Standardized Investigation and Diagnosis of the Infertile Couple. Cambridge University Press, Cambridge.
[4]
Shange, N. Male Infertility in Africa: Breaking the Stigma. https://www.sowetanlive.co.za/good-life/health/2018-07-16-male-infertility-in-africa-breaking-the-stigma/
[5]
Kersian, M. https://medium.com/@Episona/what-is-sperm-dna-fragmentation-5c7245591570
[6]
Jequier, A.M. (2004) Clinical Andrology—Still a Major Problem in the Treatment of Infertility. Human Reproduction, 19, 1245-1249. https://doi.org/10.1093/humrep/deh269
[7]
Cho, C.L. and Agarwal, A. (2017) Role of Sperm DNA Fragmentation in Male Factor Infertility: A Systematic Review. Arab Journal of Urology, 16, 21-34.
[8]
Bradley, C.K., McArthur, S.J., Gee, A.J., Weiss, K.A., Schmidt, U. and Toogood, L. (2016) Intervention Improves Assisted Conception Intracytoplasmic Sperm Injection Outcomes for Patients with High Levels of Sperm DNA Fragmentation: A Retrospective Analysis. Andrology, 4, 903-910. https://doi.org/10.1111/andr.12215
[9]
Gavriliouk, D. and Aitken, R.J. (2015) Damage to Sperm DNA Mediated by Reactive Oxygen Species: Its Impact on Human Reproduction and the Health Trajectory of Off spring. Advances in Experimental Medicine and Biology, 868, 23-47. https://doi.org/10.1007/978-3-319-18881-2_2
[10]
Aitken, R.J., Smith, T.B., Jobling, M.S., Baker, M.A. and De Iuliis, G.N. (2014) Oxidative Stress and Male Reproductive Health. Asian Journal of Andrology, 16, 31-38. https://doi.org/10.4103/1008-682X.122203
[11]
Wright, C., Milne, S. and Leeson, H. (2014) Sperm DNA Damage Caused by Oxidative Stress: Modifiable Clinical, Lifestyle and Nutritional Factors in Male Infertility. Reproductive BioMedicine Online, 28, 684-703. https://doi.org/10.1016/j.rbmo.2014.02.004
[12]
Gunes, S., Al-Sadaan, M. and Agarwal, A. (2015) Spermatogenesis, DNA Damage and DNA Repair Mechanisms in Male Infertility. Reproductive BioMedicine Online, 31, 309-319. https://doi.org/10.1016/j.rbmo.2015.06.010
[13]
Humm, K.C. and Sakkas, D. (2013) Role of Increased Male Age in IVF and Egg Donation: Is Sperm DNA Fragmentation Responsible? Fertility and Sterility, 99, 30-36. https://doi.org/10.1016/j.fertnstert.2012.11.024
[14]
Boscoa, L., Notari, T., Ruvolo, G., Roccheri, M.C., Martino, C., Chiappetta, R., Carone, D., Bosco, G., Carrillo, L., Raimondo, S., Guglielmino, A. and Montano, L. (2018) Sperm DNA Fragmentation: An Early and Reliable Marker of Air Pollution. Environmental Toxicology and Pharmacology, 58, 243-249. https://doi.org/10.1016/j.etap.2018.02.001
[15]
Cabler, S., Agarwal, A., Flint, M. and Du Plessis, S. (2010) Obesity: Modern Man’s Fertility Nemesis. Asian Journal of Andrology, 12, 480-489. https://doi.org/10.1038/aja.2010.38
Wdowiak, A., Wdowiak, A., Bakalczuk, S. and Bakalczuk, G. (2016) Relationship between Alcohol Consumption and Sperm Nuclear DNA Fragmentation and Pregnancy. Advances in Andrology Online, 3, 14-21.
[18]
Anifandis, G., Bounartzi, T., Messini, C.I., Dafopoulos, K., Sotiriou, S. and Messinis, I.E. (2014) The Impact of Cigarette Smoking and Alcohol Consumption on Sperm Parameters and Sperm DNA Fragmentation (SDF) Measured by Halosperm. Archives of Gynecology and Obstetrics, 290, 777. https://doi.org/10.1007/s00404-014-3281-x
[19]
Sharif, K. (2013) Sperm DNA Fragmentation Testing: To Do or Not to Do? Middle East Fertility Society Journal, 18, 78-83. https://doi.org/10.1016/j.mefs.2013.02.001
[20]
Lewis Sheena, E.M., John Aitken, R., Conner, S.J., De Iuliis, G., Evenson, D.P., Henkel, R., Giwercman, A. and Gharagozloo, P. (2013) The Impact of Sperm DNA Damage in Assisted Conception and Beyond: Recent Advances in Diagnosis and Treatment. Reproductive BioMedicine Online, 27, 325-337.
[21]
Lewis, S.E.M. (2013) The Place of Sperm DNA Fragmentation Testing in Current Day Fertility Management. Middle East Fertility Society Journal, 18, 78-83. https://doi.org/10.1016/j.mefs.2013.01.010
[22]
Fernández, J.L., Muriel, L., Rivero, M.T., Goyanes, V., Vazquez, R. and Alvarez, J.G. (2003) The Sperm Chromatin Dispersion Test: A Simple Method for the Determination of Sperm DNA Fragmentation. Journal of Andrology, 24, 59-66.
[23]
TDL Andrology. Information about Sperm DNA Fragmentation for Clinicians. https://tdlpathology.com/services-divisions/tdl-andrology/sperm-dnafragmentation
[24]
Simon, L., Brunborg, G., Stevenson, M., Lutton, D., McManus, J., et al. (2010) Clinical Significance of Sperm DNA Damage in Assisted Reproduction Outcome. Human Reproduction, 25, 1594-1608. https://doi.org/10.1093/humrep/deq103
[25]
Esteves, S.C. and Agarwal, A. (2011) Novel Concepts in Male Infertility. International Brazilian Journal of Urology, 37, 5-15. https://doi.org/10.1590/S1677-55382011000100002
[26]
Piasecka, M., Gaczarzewicz, D. and Laszczyriska, M. (2006) Evaluation of Sperm Genomic Integrity of Normozoospermic Men: A Prospective Study. Folia Histochemica et Cytobiologica, 44, 117-122.
[27]
Micinski, P., Pawlicki, K., Wielgus, E., Bochenek, M., Gogol, P., et al. (2011) Total Reactive Antioxidant Potential and DNA Fragmentation Index as Fertility Sperm Parameters. Reproductive Biology, 11, 135-144. https://doi.org/10.1016/S1642-431X(12)60050-3
[28]
Altura, B.M., Shah, N.C., Shah, G.J., Pérez-Abela, J.L. and Altura, B.T. (2016) Magnesium Deficiency Results in Oxidation and Fragmentation of DNA, Down Regulation of Telomerase Activity, and Ceramide Release in Cardiovascular Tissues and Cells: Potential Relationship to Atherogenesis, Cardiovascular Diseases and Aging. International Journal of Diabetology & Vascular Disease Research, 4, 1-5.
[29]
Majzoub, A., Arafa, M., Mahdi, M., Agarwal, A., Al Said, S., Al-Emadi, I., El Ansari, W., Alattar, A., Al Rumaihi, K. and Elbardisi, H. (2018) Oxidation-Reduction Potential and Sperm DNA Fragmentation, and Their Associations with Sperm Morphological Anomalies amongst Fertile and Infertile Men. Arab Journal of Urology, 16, 87-95. https://doi.org/10.1016/j.aju.2017.11.014
[30]
Liuzzo, G., Biasucci, L.M., Gallimore, J.R., Grillo, R.L., Rebuzzi, A.G., Pepys, M.B. and Maseri, A. (1994) The Prognostic Value of C-Reactive Protein and Serum Amyloid a Protein in Severe Unstable Angina. The New England Journal of Medicine, 331, 417-424. https://doi.org/10.1056/NEJM199408183310701
[31]
Ridker, P.M. (2001) High-Sensitivity C-Reactive Protein: Potential Adjunct for Global Risk Assessment in the Primary Prevention of Cardiovascular Disease. Circulation, 103, 1813-1818. https://doi.org/10.1161/01.CIR.103.13.1813
[32]
Ridker, P.M., Cushman, M., Stampfer, M.J., Tracy, R.P. and Hennekens, C.H. (1997) Inflammation, Aspirin, and the Risk of Cardiovascular Disease in Apparently healthy Men. The New England Journal of Medicine, 336, 973-979. https://doi.org/10.1056/NEJM199704033361401
[33]
Kotani, K. and Sakane, N. (2012) C-Reactive Protein and Reactive Oxygen Metabolites in Subjects with Metabolic Syndrome. The Journal of International Medical Research, 40, 1074-1081. https://doi.org/10.1177/147323001204000326
[34]
Agarwal, A. and Wang, S.M. (2017) Clinical Relevance of Oxidation-Reduction Potential in the Evaluation of Male Infertility. Urology, 104, 84-89. https://doi.org/10.1016/j.urology.2017.02.016
[35]
Fariello, R.M., Pariz, J.R., Spaine, D.M., Cedenho, A.P., Bertolla, R.P. and Fraietta, R. (2012) Association between Obesity and Alteration of Sperm DNA Integrity and Mitochondrial Activity. BJU International, 110, 863-867. https://doi.org/10.1111/j.1464-410X.2011.10813.x
[36]
Dupont, C., Faure, C., Sermondade, N., Boubaya, M., Eustache, F., Clement, P., Pascal Briot, P., et al. (2013) Obesity Leads to Higher Risk of Sperm DNA Damage in Infertile Patients. Asian Journal of Andrology, 15, 622-625. https://doi.org/10.1038/aja.2013.65
[37]
Vitiazeva, I.I., Altashina, M.V., Mun, T.V. and Troshina, E.A. (2015) Influence of Obesity on Sperm DNA Fragmentation Index and Outcomes of IVF Programs. Problems of Endocrinology, 61, 48-55. https://doi.org/10.14341/probl201561548-55
[38]
Komiya, A., Kato, T., Kawauchi, Y., Watanabe, A. and Fuse, H. (2014) Clinical Factors Associated with Sperm DNA Fragmentation in Male Patients with Infertility. The Scientific World Journal, 2014, Article ID: 868303.
[39]
Vellani, E., Colasante, A., Mamazza, L., Minasi, M.G., Greco, E. and Bevilacqua, A. (2013) Association of State and Trait Anxiety to Semen Quality of in Vitro Fertilization Patients: A Controlled Study. Fertility and Sterility, 99, 1565-1572. https://doi.org/10.1016/j.fertnstert.2013.01.098
[40]
Pourentezari, M., Talebi, A.R., Mangoli, E., Anvari, M. and Rahimipour, M. (2016) Additional Deleterious Effects of Alcohol Consumption on Sperm Parameters and DNA Integrity in Diabetic Mice. Andrologia, 48, 564-569. https://doi.org/10.1111/and.12481
[41]
Talebi, A.R., Sarcheshmeh, A.A., Khalili, M.A. and Tabibnejad, N. (2011) Effects of Ethanol Consumption on Chromatin Condensation and DNA Integrity of Epididymal Spermatozoa in Rats. Alcohol, 45, 403-409. https://doi.org/10.1016/j.alcohol.2010.10.005
[42]
Galicia-Moreno, M. and Gutiérrez-Reyes, G. (2014) The Role of Oxidative Stress in the Development of Alcoholic Liver Disease. Revista de Gastroenterología de México, 79, 135-144. https://doi.org/10.1016/j.rgmx.2014.03.001
[43]
Ozbek, E. (2012) Induction of Oxidative Stress in Kidney. International Journal of Nephrology, 2012, Article ID: 465897. https://doi.org/10.1155/2012/465897
[44]
Rosenblum, E.R., Gavaler, J.S. and Van Thiel, D.H. (1989) Lipid Peroxidation: A Mechanism for Alcohol Induced Testicular Injury. Free Radical Biology & Medicine, 7, 569-577. https://doi.org/10.1016/0891-5849(89)90034-8
[45]
Zakhari, S. (2006) Overview: How Is Alcohol Metabolized by the Body? Alcohol Research & Health, 29, 245-254.
[46]
Dosumu, O.O., Osinubi, A.A. and Duru, F.I.O. (2014) Alcohol Induced Testicular Damage: Can Abstinence Equal Recovery? Middle East Fertility Society Journal, 19, 221-228. https://doi.org/10.1016/j.mefs.2014.01.003
[47]
Himabindua, B., Madhua, P. and Sreenivasula-Reddy, P. (2015) Diabetes and Alcohol: Double Jeopardy with Regard to Oxidative Toxicity and Sexual Dysfunction in Adult Male Wistar Rats. Reproductive Toxicology, 51, 57-63. https://doi.org/10.1016/j.reprotox.2014.12.010
[48]
La Vignera, S., Condorelli, R.A., Balercia, G., Vicari, E. and Calogero, A.E. (2013) Does Alcohol Have Any Effect on Male Reproductive Function? A Review of Literature. Asian Journal of Andrology, 15, 221-225. https://doi.org/10.1038/aja.2012.118
[49]
Nordmann, R. (1994) Alcohol and Antioxidant Systems. Alcohol, 29, 513-522.
[50]
Frączek, M. and Kurpisz, M. (2015) Mechanisms of the Harmful Effects of Bacterial Semen Infection on Ejaculated Human Spermatozoa: Potential Inflammatory Markers in Semen. Folia Histochemica et Cytobiologica, 53, 201-217. https://doi.org/10.5603/fhc.a2015.0019
[51]
Morris, I.D., Ilott, S., Dixon, L. and Brison, D.R. (2002) The Spectrum of DNA Damage in Human Sperm Assessed by Single Cell Gel Electrophoresis (Comet Assay) and Its Relationship to Fertilization and Embryo Development. Human Reproduction, 17, 990-908. https://doi.org/10.1093/humrep/17.4.990
[52]
Singh, N.P., Muller, C.H. and Berger, R.E. (2003) Effects of Age on DNA Double Strand Breaks and Apoptosis in Human Sperm. Fertility and Sterility, 80, 1420-1430. https://doi.org/10.1016/j.fertnstert.2003.04.002
