Assessment of DNA fragmentation of spermatozoa that were surgically retrieved from men with obstructive azoospermia

Objective: To determine the degree of DNA fragmentation in spermatozoa of men with obstructive azoospermia or anejaculation compared with that of ejaculated spermatozoa from fertile donors. Design: Observational study. Setting: University Medical Center St. Radboud, Nijmegen. The Netherlands. Patient(s): Forty-one patients with obstructive azoospermia or anejaculation and 10 fertile donors. Main Outcome Measures(s): Sperm samples were obtained surgically from the epididymis or testis of men with azoospermia or anejeculation and by ejaculation in fertile patients. DNA fragmentation was analyzed in the total sample and in a motile fraction that was isolated as in routine ICSI procedures. DNA breaks were measured by using the TdT-mediated dUTP nick-end labeling assay. Result(s): A higher percentage of cells with DNA breaks was found in men with obstructive azoospermia or anejaculation compared with donors (mean, 18.9% vs. 6.2%). A significant lower degree of DNA fragmentation was observed in the motile fraction from patients compared with donors (0.4% vs. 0.6%). Conclusion(s): High percentages of cells with DNA damage were found in sperm samples from men with obstructive azoospermia or anejaculation, but a very low frequency of damage to the DNA was observed in the motile fraction. In an ICSI setting, the use of motile sperm retrieved from epididymis or testis of men with obstructive azoospermia does not seem to pose a higher genetic risk to the progeny than does use of motile ejaculated sperm. (Fertil Steril(R) 2002;77:233-7. (C) 2002 by American Society for Reproductive Medicine.).