Utility of the Sperm Chromatin Structure Assay (SCSA) in the Human Reproductive Medical Clinic

Understanding the mechanisms leading to abnormal sperm chromatin structure and the affect on the developing pregnancies is critical due to the liberal use of ICSI in ART laboratories. The SCSA provides a rapid, unbiased, quantitative assessment of sperm chromatin structure that is an independent predictor of in vivo as well as in vitro infertility, i.e., pregnancy. The utility of the SCSA in the clinical laboratory was shown by its ability to predict infertility independent of conventional semen parameters. This information is invaluable for couples who may choose to discontinue ART or consider donor insemination when sperm chromatin structure is most likely incompatible with fertility. Laboratories included in the studies reported in this dissertation have begun to initiate the use of SCSA as a part of male fertility evaluations. Therefore, the assessment of the sperm chromatin structure by the SCSA was shown to be a valuable addition to standard infertility assessments; predicting and thereby preventing patients the medical, emotional and financial costs of failed ART. The SCSA also has shown its utility in identifying the timing and spatial aspects of ROS induced chromatin abnormalities. This is critical to understanding the mechanisms leading to abnormal chromatin structure and may be an initial step in developing treatments to prevent such damage. Therefore, this dissertation research has successfully confirmed and expanded the utility of the SCSA in the clinical andrology laboratory and has enhanced our knowledge of the biological mechanisms leading to abnormal chromatin structure and associated infertility