Can Utilization of Sperm DNA Fragmentation (SDA) Tests in Combination with Time Lapse Microscopy Help in Improving ICSI Implantation Rates in Unexplained Recurrent Implantation Failures Utilizing Double Stranded SDA as the Causative Factor for the same

Over 50% of intracytoplasmic sperm injection (ICSI) cycles don’t display implantation. Hence laboratories make their maximum efforts to select the best embryos as far as implantation enhancement is concerned. Further utilization of available technologies like time lapse recording have been made in a large number of artificial reproductive technology (ART) centres. Various studies that utilize embryo kinetics have implicated that time when embryo cleavage may prove to be an important factor that determines the implantation potential of an embryo. With this variety of algorithms mathematic wise have been used to forecast which the best embryos are for transfer. But the efficacy of these might be influenced by multiple confounding factors. Thus work on biomarkers that can forecast good ART warrants newer embryo selection basis. Regarding conventional ICSI, typical standard routine semen analysis involving sperm concentration, motility and morphology does not predict the implantation percentages in an ICSI cycle. Once sperm DNA fragmentation (SDA) methods were inducted they appeared to hold promise in forecasting good ART success. Although certain studies utilizing various techniques like TUNEL. SCSA, SCD proved a relation existed between DNA damage and implantation rates in ICSI but the same was contradicted by others. With this it was thought that bias between evaluation of ejaculate and motile sperm picked up for ICSI, as is known regarding absence of positive association of sperm motility and DNA fragmentation. Thus study by Casanovas et.al., tried to find if there is any correlation of single stranded (ssSDA) and double stranded (dsSDA) sperm DNA damage that might forecast ICSI success and utilizing Neutral Comet Assays along with help of time lapse technology they found that double stranded sperm influenced delay in embryo formation as seen by embryo kinetics and thus interfere with implantation rates. Reproduction of these findings might help in getting a standard for getting best embryos selected in ICSI utilizing SDA and time lapse microscopy.