Seprm structure and how safe is ART ??

Investigate and treat  with full consent of couple, additionally we must aim at  “Adaptation and Personalization of fertility therapy “-WE call it Individualization. No generalization i,.e  we should proceed  as per  need of each couple may be  different ,This will    help   to optimize the efficacy and safety   of assisted   reproductive technology  . The outcome    should not only be limited to clinical pregnancy rates and live birth rate but   should also include perinatal outcome. Not  to rush for ART as an initial step as there is a definite   a higher   risk of adverse perinatal  outcome  with some ART   procedures the absolute  rise in the risk is   low.  Many studies have looked that long term risk of infants born out of ART procedures have some marginally excess     congenital anomalies   and neonatal complications have been reported.

Sperm is a very sophisticated   toolbox and an optimally elected cell with high    quality DNA centrosome RNA   species   Histone code and as yet unknown factors. Semen   analysis is an essential part of infertility    investigations but its diagnostic value   for male infertility and also prognostic    value specially for  ART   outcome   is limited. Thus basic   semen analysis    gives information about the messenger    whereas   sperm DNA integrity tests reveal information about the message  . Nuclear DNA anomalies lead to failure   of fertilization in vitro   resulting in “fertilization failure “  to implant after intracytoplasmic sperm injection      and increased time    of conception .

1)                 DNA damage can affect    the motility of sperm and DNA damage have  a   2) negative influence of blastocyst development .3)  more oxidative   stressà more is the  DNA   damage       4) MAGI-à leukocytospermia due to infn of male accessory glands   may not only cause impaired sperm motility but also  DNA   damage. Further, leukocytospermia is one of the main   causes of oxidative stress.. 4)   How important is male accessory glands?  The improper function of such glands (S vesicles, prostrate)      not only yield to more  DFI(DNA Fragmentation Index)   but also    the proper orderly functionality    of accessory  glands    is  essential    for advanced sperm    function  . 5) There is correlation between seminal adenosine deaminase and increased   sperm DNA damage thus making  it a good indicator of male genital tract    inflammation(MAGI = male genital Tract infection)  and low quality. semen.6) Seldom we look at the report page about fructose and citric acid us rarely estimated at the lost cost of 500-1000 /-of routine semen analysis,. But fact is even evaluation of  fructose  and citric   acid can   help in understanding the sperm function.

2)                 There was   another  study which  looked   at the effect of increased DNA   damage  on the outcome of intrauterine   insemination and ICSI. This study   concluded that increased DNA   fragmentation   index   decreases   the pregnancy    rates only  in ICSI  cycles. We are also aware that increased   reactive   oxygen   species  is associated with oxidative stress.