Highlights from

EAU 2019

European Association of Urology annual congress

Barcelona 15-19 March 2019

DNA of sperm taken directly from testicles of infertile men is “as good as sperm from fertile men”, possibly opening way for new treatment

Sperm DNA from the testicles of many infertile men is as good as that of ejaculated sperm of fertile men. This may explain a major cause of male infertility and opens the possibility of using sperm taken directly from the testicles of these men; to overcome their infertility.

Infertility is a major public health issue. One couple in 6 is infertile across Europe [1], with male infertility now being the biggest cause in couples seeking treatment. Sperm DNA damage is known to be a major cause of male infertility and reduces a couple’s chances of having a family. This study shows that on the journey from the testicles along the long series of ducts before ejaculation, sperm DNA can suffer major damage partly attributable to oxidative stress.

In new research presented at the EAU, UK-based scientists took sperm samples from the testicles from 63 infertile men, and matched them with ejaculated sperm samples from the same men. The infertile cohort of men had all failed previous fertility treatment. The scientists also examined the sperm for two types of DNA damage in both the testicular and ejaculated sperm. A group of 76 fertile volunteers also gave ejaculated sperm for comparison. The group measured the extent and nature of DNA damage.

According to the lead researcher Jonathan Ramsay (London, United Kingdom): “When we looked at ejaculated sperm, we found that the extent of sperm DNA damage was much higher in infertile men (with 40%) than in fertile men, with roughly 15%. It wasn’t a surprise to see greater DNA damage in ejaculates of infertile men. What we didn’t expect was the consistency in these results when we looked at sperm taken directly from the testicles of infertile men, we found that it was of similar quality to that of ejaculated, fertile sperm”.

Commenting, Prof. Maarten Albersen (University Hospital Leuven, Belgium) said: “In this study, a group from London shows that DNA integrity in infertile men is higher in testicular sperm than in ejaculated sperm. As DNA integrity is believed to play a role in fertilisation rates in assisted reproduction, these results may assist in the decision-making whether or not to resort to testicular biopsy/testicular sperm aspiration rather than using ejaculated sperm to enhance success rates of assisted fertilisation in infertile men with signs of DNA damage. However, improved fertilisation rates and baby take-home rates would need to be confirmed before adopting this alternate strategy”.

The content and interpretation of these conference highlights are the views and comments of the speakers/authors.