Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-08T01:21:55.687Z Has data issue: false hasContentIssue false

Chapter 24 - Clinical Value of Sperm Function Tests

Published online by Cambridge University Press:  05 April 2021

Ashok Agarwal
Affiliation:
The Cleveland Clinic Foundation, Cleveland, OH
Ralf Henkel
Affiliation:
University of the Western Cape, South Africa
Ahmad Majzoub
Affiliation:
Hamad Medical Corporation, Doha
Get access

Summary

Infertility is a major public health concern affecting up to 25 percent of couples worldwide [1]. It is defined by the failure of a couple to achieve conception after one year of regular, unprotected intercourse. The male contributes to roughly 50 percent of the causes of infertility among couples highlighting the importance of research and development in this field of medicine [2]. Conventional semen analysis is the cornerstone test for evaluating the male factor [3]. While the test can provide a general understanding of the male fertility potential, it cannot be used as an accurate predictor of fecundity. About 10 percent of men with normal semen analysis are unable to conceive. On the contrary, an equal percentage of men with abnormal semen analysis have no issues with fertility [4]. Therefore, during the past few decades, the low predictive power of standard semen analysis has triggered researchers to look for more sensitive and specific tests of sperm function. This chapter aims to explore the clinical utility of various tests of sperm function that have been described in literature.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Boivin, J, Bunting, L, Collins, JA, Nygren, KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Hum Reprod 2007; 22: 1506–12.CrossRefGoogle ScholarPubMed
Brugh, VM, Lipshultz, LI. Male factor infertility: evaluation and management. Med Clin North Am 2004; 88: 367–85.Google Scholar
Cooper, TG, Noonan, E, von Eckardstein, S, Auger, J, Baker, HW et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231–45.Google Scholar
Sadeghi, MR. The state of semen analysis over time. J Reprod Infertil 2014; 15: 1.Google Scholar
Agarwal, A, Gupta, S, Sikka, S. The role of free radicals and antioxidants in reproduction. Curr Opin Obstet Gynecol 2006; 18: 325–32.Google Scholar
Agarwal, A, Saleh, RA, Bedaiwy, MA. Role of reactive oxygen species in the pathophysiology of human reproduction. Fertil Steril 2003; 79: 829–43.CrossRefGoogle ScholarPubMed
Agarwal, A, Said, TM. Oxidative stress, DNA damage and apoptosis in male infertility: a clinical approach. BJU International 2005; 95: 503–7.CrossRefGoogle ScholarPubMed
Agarwal, A, Virk, G, Ong, C, du Plessis, SS. Effect of oxidative stress on male reproduction. World J Mens Health 2014; 32: 117.Google Scholar
Aitken, RJ, Jones, KT, Robertson, SA. Reactive oxygen species and sperm function--in sickness and in health. J Androl 2012; 33: 1096–106.Google Scholar
Aitken, RJ, Wingate, JK, De Iuliis, GN, McLaughlin, EA. Analysis of lipid peroxidation in human spermatozoa using BODIPY C11. Mol Hum Reprod 2007; 13: 203–11.CrossRefGoogle ScholarPubMed
Bansal, AK, Bilaspuri, GS. Impacts of oxidative stress and antioxidants on semen functions. Vet Med Int 2010; 2010.Google ScholarPubMed
. Dandekar, SP, Nadkarni, GD, Kulkarni, VS, Punekar, S. Lipid peroxidation and antioxidant enzymes in male infertility. J Postgrad Med 2002; 48: 186–9; discussion 9–90.Google ScholarPubMed
Homa, ST, Vessey, W, Perez-Miranda, A, Riyait, T, Agarwal, A. Reactive Oxygen Species (ROS) in human semen: determination of a reference range. J Assist Reprod Genet 2015; 32: 757–64.Google Scholar
Agarwal, A, Sharma, RK, Sharma, R, Assidi, M, Abuzenadah, AM et al. Characterizing semen parameters and their association with reactive oxygen species in infertile men. Reprod Biol Endocrinol 2014; 12: 33.Google Scholar
Venkatesh, S, Singh, G, Gupta, NP, Kumar, R, Deecaraman, M et al. Correlation of sperm morphology and oxidative stress in infertile men. Iran J Reprod Med 2009; 7: 2934.Google Scholar
Majzoub, A, Arafa, M, Mahdi, M, Agarwal, A, Al Said, S et al. Oxidation-reduction potential and sperm DNA fragmentation, and their associations with sperm morphological anomalies amongst fertile and infertile men. Arab J Urol 2018; 16: 8795.Google Scholar
Aitken, RJ, De Iuliis, GN. On the possible origins of DNA damage in human spermatozoa. Mol Hum Reprod 2010; 16: 313.Google Scholar
Aitken, RJ, Krausz, C. Oxidative stress, DNA damage and the Y chromosome. Reproduction 2001; 122: 497506.Google Scholar
Saleh, RA, Agarwal, A, Nada, EA, El-Tonsy, MH, Sharma, RK et al. Negative effects of increased sperm DNA damage in relation to seminal oxidative stress in men with idiopathic and male factor infertility. Fertil Steril 2003; 79(Suppl. 3): 1597–605.CrossRefGoogle ScholarPubMed
Wright, C, Milne, S, Leeson, H. Sperm DNA damage caused by oxidative stress: modifiable clinical, lifestyle and nutritional factors in male infertility. Reprod Biomed Online 2014; 28: 684703.CrossRefGoogle ScholarPubMed
Agarwal, A, Esteves, SC. Varicocele and male infertility: current concepts and future perspectives. Asian J Androl 2016; 18: 161–2.Google Scholar
Cho, CL, Esteves, SC, Agarwal, A. Novel insights into the pathophysiology of varicocele and its association with reactive oxygen species and sperm DNA fragmentation. Asian J Androl 2016; 18: 186–93.Google Scholar
Agarwal, A, Prabakaran, S, Allamaneni, SS. Relationship between oxidative stress, varicocele and infertility: a meta-analysis. Reprod Biomed Online 2006; 12: 630–3.CrossRefGoogle ScholarPubMed
Majzoub, A, Esteves, SC, Gosalvez, J, Agarwal, A. Specialized sperm function tests in varicocele and the future of andrology laboratory. Asian J Androl 2016; 18: 205–12.CrossRefGoogle ScholarPubMed
Sakamoto, Y, Ishikawa, T, Kondo, Y, Yamaguchi, K, Fujisawa, M. The assessment of oxidative stress in infertile patients with varicocele. BJU International 2008; 101: 1547–52.CrossRefGoogle ScholarPubMed
Allamaneni, SS, Naughton, CK, Sharma, RK, Thomas, AJ, Jr., Agarwal, A. Increased seminal reactive oxygen species levels in patients with varicoceles correlate with varicocele grade but not with testis size. Fertil Steril 2004; 82: 1684–6.Google Scholar
Mostafa, T, Anis, T, Imam, H, El-Nashar, AR, Osman, IA. Seminal reactive oxygen species-antioxidant relationship in fertile males with and without varicocele. Andrologia 2009; 41: 125–9.Google Scholar
Mehraban, D, Ansari, M, Keyhan, H, Sedighi Gilani, M, Naderi, G et al. Comparison of nitric oxide concentration in seminal fluid between infertile patients with and without varicocele and normal fertile men. J Urol 2005; 2: 106–10.Google ScholarPubMed
Xu, Y, Xu, QY, Yang, BH, Zhu, XM, Peng, YF. Relationship of nitric oxide and nitric oxide synthase with varicocele infertility. Zhonghua nan ke xue [National Journal of Andrology] 2008; 14: 414–17.Google Scholar
Abd-Elmoaty, MA, Saleh, R, Sharma, R, Agarwal, A. Increased levels of oxidants and reduced antioxidants in semen of infertile men with varicocele. Fertil Steril 2010; 94: 1531–4.Google Scholar
Mostafa, T, Anis, T, El Nashar, A, Imam, H, Osman, I. Seminal plasma reactive oxygen species-antioxidants relationship with varicocele grade. Andrologia 2012; 44: 66–9.Google Scholar
Mazzilli, F, Rossi, T, Marchesini, M, Ronconi, C, Dondero, F. Superoxide anion in human semen related to seminal parameters and clinical aspects. Fertil Steril 1994; 62: 862–8.Google Scholar
Hamada, A, Esteves, SC, Agarwal, A. Insight into oxidative stress in varicocele-associated male infertility: part 2. Nat Rev Urol 2013; 10: 2637.Google Scholar
Mostafa, T, Anis, TH, El-Nashar, A, Imam, H, Othman, IA. Varicocelectomy reduces reactive oxygen species levels and increases antioxidant activity of seminal plasma from infertile men with varicocele. Int J Androl 2001; 24: 261–5.CrossRefGoogle ScholarPubMed
de Catalfo GE, Hurtado, Ranieri-Casilla, A, Marra, FA, de Alaniz MJ, , Marra, CA. Oxidative stress biomarkers and hormonal profile in human patients undergoing varicocelectomy. Int J Androl 2007; 30: 519–30.Google Scholar
Saleh, RA, Agarwal, A, Sharma, RK, Nelson, DR, Thomas, AJ, Jr. Effect of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study. Fertil Steril 2002; 78: 491–9.Google Scholar
Taha, EA, Ez-Aldin, AM, Sayed, SK, Ghandour, NM, Mostafa, T. Effect of smoking on sperm vitality, DNA integrity, seminal oxidative stress, zinc in fertile men. Urology 2012; 80: 822–5.Google Scholar
Jurewicz, J, Radwan, M, Sobala, W, Radwan, P, Bochenek, M et al. Effects of occupational exposure - is there a link between exposure based on an occupational questionnaire and semen quality? Syst Biol Reprod Med 2014; 60: 227–33.CrossRefGoogle Scholar
Taha, EA, Sayed, SK, Ghandour, NM, Mahran, AM, Saleh, MA et al. Correlation between seminal lead and cadmium and seminal parameters in idiopathic oligoasthenozoospermic males. Cent European J Urol 2013; 66: 8492.Google Scholar
Jeng, HAC, Lin, WY, Chao, MR, Lin, WY, Pan, CH. Semen quality and sperm DNA damage associated with oxidative stress in relation to exposure to polycyclic aromatic hydrocarbons. J Environ Sci Health A Tox Hazard Subst Environ Eng 2018; 53: 1221–8.Google Scholar
Ghaleno, LR, Valojerdi, MR, Hassani, F, Chehrazi, M, Janzamin, E. High level of intracellular sperm oxidative stress negatively influences embryo pronuclear formation after intracytoplasmic sperm injection treatment. Andrologia 2014; 46: 1118–27.Google Scholar
Takenaka, M, Horiuchi, T, Yanagimachi, R. Effects of light on development of mammalian zygotes. Proc Natl Acad Sci U S A 2007; 104: 14289–93.CrossRefGoogle ScholarPubMed
Guerin, P, El Mouatassim, S, Menezo, Y. Oxidative stress and protection against reactive oxygen species in the pre-implantation embryo and its surroundings. Hum Reprod Update 2001; 7: 175–89.Google Scholar
Larkindale, J, Knight, MR. Protection against heat stress-induced oxidative damage in Arabidopsis involves calcium, abscisic acid, ethylene, and salicylic acid. Plant Physiol 2002; 128: 682–95.Google Scholar
Shekarriz, M, DeWire, DM, Thomas, AJ, Jr., Agarwal, A. A method of human semen centrifugation to minimize the iatrogenic sperm injuries caused by reactive oxygen species. Eur Urol 1995; 28: 31–5.Google Scholar
Alvarez, JG, Storey, BT. Evidence for increased lipid peroxidative damage and loss of superoxide dismutase activity as a mode of sublethal cryodamage to human sperm during cryopreservation. J Androl 1992; 13: 232–41.Google Scholar
Alvarez, JG. DNA fragmentation in human spermatozoa: significance in the diagnosis and treatment of infertility. Minerva Ginecol 2003; 55: 233–9.Google ScholarPubMed
Irvine, DS, Twigg, JP, Gordon, EL, Fulton, N, Milne, PA et al. DNA integrity in human spermatozoa: relationships with semen quality. J Androl 2000; 21: 3344.CrossRefGoogle ScholarPubMed
Erenpreiss, J, Spano, M, Erenpreisa, J, Bungum, M, Giwercman, A. Sperm chromatin structure and male fertility: biological and clinical aspects. Asian J Androl 2006; 8: 1129.Google Scholar
Sakkas, D, Moffatt, O, Manicardi, GC, Mariethoz, E, Tarozzi, N et al. Nature of DNA damage in ejaculated human spermatozoa and the possible involvement of apoptosis. Biol Reprod 2002; 66: 1061–7.CrossRefGoogle ScholarPubMed
Moustafa, MH, Sharma, RK, Thornton, J, Mascha, E, Abdel-Hafez, MA et al. Relationship between ROS production, apoptosis and DNA denaturation in spermatozoa from patients examined for infertility. Hum Reprod 2004; 19: 129–38.Google Scholar
Agarwal, A, Cho, CL, Esteves, SC. Should we evaluate and treat sperm DNA fragmentation? Curr Opin Obstet Gynecol 2016; 28: 164–71.Google Scholar
Arafa, M, AlMalki, A, AlBadr, M, Burjaq, H, Majzoub, A et al. ICSI outcome in patients with high DNA fragmentation: testicular versus ejaculated spermatozoa. Andrologia 2018; 50(1). doi: 10.1111/and.12835.Google Scholar
Benchaib, M, Lornage, J, Mazoyer, C, Lejeune, H, Salle, B et al. Sperm deoxyribonucleic acid fragmentation as a prognostic indicator of assisted reproductive technology outcome. Fertil Steril 2007; 87: 93100.Google Scholar
Kumar, K, Deka, D, Singh, A, Mitra, DK, Vanitha, BR et al. Predictive value of DNA integrity analysis in idiopathic recurrent pregnancy loss following spontaneous conception. J Assist Reprod Genet 2012; 29: 861–7.Google Scholar
Lopez, G, Lafuente, R, Checa, MA, Carreras, R, Brassesco, M. Diagnostic value of sperm DNA fragmentation and sperm high-magnification for predicting outcome of assisted reproduction treatment. Asian J Androl 2013; 15: 790–4.Google Scholar
Santi, D, Spaggiari, G, Simoni, M. Sperm DNA fragmentation index as a promising predictive tool for male infertility diagnosis and treatment managementmeta-analyses. Reprod Biomed Online 2018; 37: 315–26.Google Scholar
Agarwal, A, Cho, CL, Majzoub, A, Esteves, SC. The Society for Translational Medicine: clinical practice guidelines for sperm DNA fragmentation testing in male infertility. Transl Androl Urol 2017; 6: S720–S33.Google Scholar
Agarwal, A, Majzoub, A, Esteves, SC, Ko, E, Ramasamy, R et al. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Transl Androl Urol 2016; 5: 935–50.CrossRefGoogle ScholarPubMed
Collins, JA, Crosignani, PG. Unexplained infertility: a review of diagnosis, prognosis, treatment efficacy and management. Int J Gynaecol Obstet 1992; 39: 267–75.Google Scholar
Bareh, GM, Jacoby, E, Binkley, P, Chang, TC, Schenken, RS et al. Sperm deoxyribonucleic acid fragmentation assessment in normozoospermic male partners of couples with unexplained recurrent pregnancy loss: a prospective study. Fertil Steril 2016; 105: 329–36 e1.Google Scholar
Oleszczuk, K, Augustinsson, L, Bayat, N, Giwercman, A, Bungum, M. Prevalence of high DNA fragmentation index in male partners of unexplained infertile couples. Andrology 2013; 1: 357–60.Google Scholar
Khadem, N, Poorhoseyni, A, Jalali, M, Akbary, A, Heydari, ST. Sperm DNA fragmentation in couples with unexplained recurrent spontaneous abortions. Andrologia 2014; 46: 126–30.Google Scholar
Leach, M, Aitken, RJ, Sacks, G. Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage. Aust N Z J Obstet Gynaecol 2015; 55: 379–83.Google Scholar
Tan, J, Taskin, O, Albert, A, Bedaiwy, MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reprod Biomed Online 2019; 38: 951–60.CrossRefGoogle Scholar
Zini, A. Are sperm chromatin and DNA defects relevant in the clinic? Syst Biol Reprod Med 2011; 57: 7885.CrossRefGoogle ScholarPubMed
Esteves, SC, Gosalvez, J, Lopez-Fernandez, C, Nunez-Calonge, R, Caballero, P et al. Diagnostic accuracy of sperm DNA degradation index (DDSi) as a potential noninvasive biomarker to identify men with varicocele-associated infertility. Int Urol Nephrol 2015; 47: 1471–7.CrossRefGoogle ScholarPubMed
Smith, R, Kaune, H, Parodi, D, Madariaga, M, Rios, R et al. Increased sperm DNA damage in patients with varicocele: relationship with seminal oxidative stress. Hum Reprod 2006; 21: 986–93.Google Scholar
Ni, K, Steger, K, Yang, H, Wang, H, Hu, K et al. Sperm protamine mRNA ratio and DNA fragmentation index represent reliable clinical biomarkers for men with varicocele after microsurgical varicocele ligation. J Urol 2014; 192: 170–6.Google Scholar
Roque, M, Esteves, SC. Effect of varicocele repair on sperm DNA fragmentation: a review. Int Urol Nephrol 2018; 50: 583603.Google Scholar
Zini, A, Dohle, G. Are varicoceles associated with increased deoxyribonucleic acid fragmentation? Fertil Steril 2011; 96: 1283–7.Google Scholar
Wang, YJ, Zhang, RQ, Lin, YJ, Zhang, RG, Zhang, WL. Relationship between varicocele and sperm DNA damage and the effect of varicocele repair: a meta-analysis. Reprod Biomed Online 2012; 25: 307–14.Google Scholar
Smit, M, Romijn, JC, Wildhagen, MF, Veldhoven, JL, Weber, RF et al. Decreased sperm DNA fragmentation after surgical varicocelectomy is associated with increased pregnancy rate. J Urol 2013; 189: S146–50.Google Scholar
Duran, EH, Morshedi, M, Taylor, S, Oehninger, S. Sperm DNA quality predicts intrauterine insemination outcome: a prospective cohort study. Hum Reprod 2002; 17: 3122–8.Google Scholar
Bungum, M, Humaidan, P, Axmon, A, Spano, M, Bungum, L et al. Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome. Hum Reprod 2007; 22: 174–9.Google Scholar
Osman, A, Alsomait, H, Seshadri, S, El-Toukhy, T, Khalaf, Y. The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: a systematic review and meta-analysis. Reprod Biomed Online 2015; 30: 120–7.CrossRefGoogle ScholarPubMed
Zini, A, Sigman, M. Are tests of sperm DNA damage clinically useful? Pros and cons. J Androl 2009; 30: 219–29.Google Scholar
Robinson, L, Gallos, ID, Conner, SJ, Rajkhowa, M, Miller, D et al. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Hum Reprod 2012; 27: 2908–17.Google Scholar
Oehninger, S, Franken, DR, Sayed, E, Barroso, G, Kolm, P. Sperm function assays and their predictive value for fertilization outcome in IVF therapy: a meta-analysis. Hum Reprod Update 2000; 6: 160–8.Google Scholar
Ulstein, M. In vitro sperm penetration of cervical mucus and male fertility. Andrology 1973; 5: 189–91.Google Scholar
Barros, C, Gonzalez, J, Herrera, E, Bustos-Obregon, E. Human sperm penetration into zona-free hamster oocytes as a test to evaluate the sperm fertilizing ability. Andrologia 1979; 11: 197210.CrossRefGoogle ScholarPubMed
Oehninger, S, Franken, DR, Ombelet, W. Sperm functional tests. Fertil Steril 2014; 102: 1528–33.Google Scholar
Mol, BW, Meijer, S, Yuppa, S, Tan, E, de Vries J, et al. Sperm penetration assay in predicting successful in vitro fertilization. A meta-analysis. J Reprod Med 1998; 43: 503–8.Google Scholar
Burkman, LJ, Coddington, CC, Franken, DR, Krugen, TF, Rosenwaks, Z et al. The hemizona assay (HZA): development of a diagnostic test for the binding of human spermatozoa to the human hemizona pellucida to predict fertilization potential. Fertil Steril 1988; 49: 688–97.Google Scholar
Liu, DY, Lopata, A, Johnston, WI, Baker, HW. A human sperm-zona pellucida binding test using oocytes that failed to fertilize in vitro. Fertil Steril 1988; 50: 782–8.Google Scholar
Oehninger, S, Morshedi, M, Franken, D. The hemizona assay for assessment of sperm function. Methods Mol Biol 2013; 927: 91102.Google Scholar
Kizilay, F, Altay, B. Sperm function tests in clinical practice. Turk J Urol 2017; 43: 393400.Google Scholar
Oehninger, S. Clinical and laboratory management of male infertility: an opinion on its current status. J Androl 2000; 21: 814–21.CrossRefGoogle ScholarPubMed
Liu, DY, Garrett, C, Baker, HW. Clinical application of sperm-oocyte interaction tests in in vitro fertilizationembryo transfer and intracytoplasmic sperm injection programs. Fertil Steril 2004; 82: 1251–63.Google Scholar
Oehninger, S, Coddington, CC, Scott, R, Franken, DA, Burkman, LJ et al. Hemizona assay: assessment of sperm dysfunction and prediction of in vitro fertilization outcome. Fertil Steril 1989; 51: 665–70.CrossRefGoogle ScholarPubMed
Franken, DR, Kruger, TF, Oehninger, S, Coddington, CC, Lombard, C et al. The ability of the hemizona assay to predict human fertilization in different and consecutive in-vitro fertilization cycles. Hum Reprod 1993; 8: 1240–4.Google Scholar
Franken, DR, Oehninger, S. The clinical significance of sperm-zona pellucida binding: 17 years later. Front Biosci 2006; 11: 1227–33.Google Scholar
Arslan, M, Morshedi, M, Arslan, EO, Taylor, S, Kanik, A et al. Predictive value of the hemizona assay for pregnancy outcome in patients undergoing controlled ovarian hyperstimulation with intrauterine insemination. Fertil Steril 2006; 85: 1697–707.Google Scholar
Liu, DY, Baker, HW. High frequency of defective sperm-zona pellucida interaction in oligozoospermic infertile men. Hum Reprod 2004; 19: 228–33.CrossRefGoogle ScholarPubMed
Oehninger, S, Franken, D, Kruger, T. Approaching the next millennium: how should we manage andrology diagnosis in the intracytoplasmic sperm injection era? Fertil Steril 1997; 67: 434–6.Google Scholar
Oehninger, S, Mahony, M, Ozgur, K, Kolm, P, Kruger, T et al. Clinical significance of human sperm-zona pellucida binding. Fertil Steril 1997; 67: 1121–7.Google Scholar
Brucker, C, Lipford, GB. The human sperm acrosome reaction: physiology and regulatory mechanisms. An update. Hum Reprod Update 1995; 1: 5162.Google Scholar
Liu, DY, Clarke, GN, Martic, M, Garrett, C, Baker, HW. Frequency of disordered zona pellucida (ZP)-induced acrosome reaction in infertile men with normal semen analysis and normal spermatozoa-ZP binding. Hum Reprod 2001; 16: 1185–90.Google Scholar
Sanchez, R, Toepfer-Petersen, E, Aitken, RJ, Schill, WB. A new method for evaluation of the acrosome reaction in viable human spermatozoa. Andrologia 1991; 23: 197203.Google Scholar
Parmegiani, L, Cognigni, GE, Ciampaglia, W, Pocognoli, P, Marchi, F et al. Efficiency of hyaluronic acid (HA) sperm selection. J Assist Reprod Genet 2010; 27: 1316.Google Scholar
Myles, DG, Primakoff, P. Why did the sperm cross the cumulus? To get to the oocyte. Functions of the sperm surface proteins PH-20 and fertilin in arriving at, and fusing with, the egg. Biol Reprod 1997; 56: 320–7.Google Scholar
Beck-Fruchter, R, Shalev, E, Weiss, A. Clinical benefit using sperm hyaluronic acid binding technique in ICSI cycles: a systematic review and meta-analysis. Reprod Biomed Online 2016; 32: 286–98.Google Scholar
Lepine, S, McDowell, S, Searle, LM, Kroon, B, Glujovsky, D et al. Advanced sperm selection techniques for assisted reproduction. Cochrane Database Syst Rev 2019; 7: CD010461.Google Scholar
Jeyendran, RS, Van der Ven, HH, Perez-Pelaez, M, Crabo, BG, Zaneveld, LJ. Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics. J Reprod Fertil 1984; 70: 219–28.Google Scholar
Liu, J, Tsai, YL, Katz, E, Compton, G, Garcia, JE et al. High fertilization rate obtained after intracytoplasmic sperm injection with 100% nonmotile spermatozoa selected by using a simple modified hypo-osmotic swelling test. Fertil Steril 1997; 68: 373–5.Google Scholar
Charehjooy, N, Najafi, MH, Tavalaee, M, Deemeh, MR, Azadi, L et al. Selection of sperm based on hypo-osmotic swelling may improve ICSI outcome: a preliminary prospective clinical trial. Int J Fertil Steril 2014; 8: 21–8.Google Scholar
Stanger, JD, Vo, L, Yovich, JL, Almahbobi, G. Hypo-osmotic swelling test identifies individual spermatozoa with minimal DNA fragmentation. Reprod Biomed Online 2010; 21: 474–84.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×