DNA fragmentation, antioxidants and ART

This chapter includes clinical cases, background, evidence-based practical management options, preventive measures, key-point summaries of DNA fragmentation, antioxidants and assisted reproduction techniques (ART) and answers to questions patients ask. Couples instead rely on ART, usually intracytoplasmic sperm injection, which is expensive, invasive and without guarantee of success. Spermatozoa are particularly sensitive to oxidative stress because of the very small amount of cytoplasm within the cell, therefore possesses limited endogenous antioxidant protection. Sperm DNA damage arising as a consequence of reactive oxygen species is highly prevalent among infertile men and is thought to impair chances of natural conception. Reproductive implications of single strand versus double strand sperm DNA damage are different, with ds DNA damage more likely to have negative impact on ART outcomes.