Male Factor Infertility (MFI) Follow-up

I've already shared with you the basics of male factor infertility (MFI) in an earlier entry (benchmarks, tests, general options), but a recent discovery is worth revising this topic.

According to this article in Scientific America, researches have managed to decode the human genome of a single sex cell. Unlike other cells, sperm and egg cells contain only a single set of chromosomes. This discovery will enable scientists to decode the genetic makeup of your partner's sperm. The hope is that it may finally give some answers to those suffering from "unexplained infertility" and will hopefully become part of the standard testing done during RE visits.

This sequencing of a full genome from a single sex cell, like the sperm (and maybe some day the egg), is expected to become available for infertility lab uses within the next five years. In the meantime, there a few options that are worth mentioning:

  • PICSI: While ICSI is commonly used in fertility clinics, surprisingly PICSI is not as prevalent. In essence, PICSI is a sperm selection method that allows embryologists to select sperm beyond just their appearance (remember morphology and motility of the sperm?) and then be ICSIed (yes, I used it as a verb!). This method entails placing the sperm in a dish that contains Hyaluronan. This is a substance found in the cells around human eggs -- and in other tissues. The theory is that mature and most importantly sperm with good DNA will bind to the Hyaluronan, hence be selected for ICSI. For what it's worth, we used this method at our last IVF cycle at CCRM. 
  • SCSA: This is another test available, perhaps closest to this new discovery, that allows us to find out more about the DNA of the sperm. SCSA (Sperm Chromatic Structure Assay) is a sperm DNA fragmentation test. In other words, it looks to find any "breaks" in the DNA of the sperm, which can be one of the reasons behind recurrent miscarriages -- sperm and egg meet, embryo is formed but quickly dies because of fragmented DNA. Now the question is, is it worth doing this test if ultimately even if the results came back positive for high fragmentation you (a) would continue to try using your partner's sperm, or (b) you would not consider using donor sperm? Those were the questions posed to us when we inquired about it with our RE. There may be value in testing if you are near the end of your rope and need to find closure.
With every discovery we seem to be coming closer to finding some answers for the millions of couples struggling with unexplained infertility and MFI. 
But like technological advances, scientific advances are very quickly replaced with other more promising discoveries. 
Would any of the above sperm selection options give you the closure you would need to stop pursuing infertility treatments if you found out that your partner's sperm just doesn't seem to make the cut?


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