Sperm chromatin structure assay: its clinical use for detecting sperm DNA fragmentation in male infertility and comparisons with other techniques
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The Sperm Chromatin Structure Assay (SCSA) was first described in the December 5, 1980 issue of Science (Evenson et al, 1980a).The data described in that article showed a significant difference between proven fertile and subfertility or infertility in men and bulls and the susceptibility to denaturation of their sperm nuclear DNA.A subsequent study (Evenson et al, 1984) described SCSA data obtained from men with testicular cancer.The data were heterogeneous, and begged the question, what was SCSA measuring?Great effort has been spent over the past 15 years on animal model systems, mostly related to dose-response toxicology experiments and large animal fertility trials.The results from these studies showed that SCSA was highly dose-responsive to toxicants, highly repeatable, and provided meaningful biological information on sperm nuclear DNA defects.The extensive data from nonhumans (Evenson et al, 1985(Evenson et al, , 1986(Evenson et al, , 1989a(Evenson et al, ,b, 1993a(Evenson et al, ,b,c, 1994(Evenson et al, , 1995b;; Ballachey et
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DNA fragmentation was assessed using the Sperm Chromatin Structure Analysis (SCSA) test.
“DNA fragmentation assessment using the Sperm Chromatin Structure Analysis (SCSA) test”
From The effect of antioxidants on male factor infertility: the Males, Antioxidants, and Infertility (MOXI) randomized clinical trial (2020) · cites this paper as [14]
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Rybouchkin, A. V., Van der Straeten, F., Quatacker, J., De Sutter, P., & Dhont, M. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)00378-6 · Cited by 169 · see citing works
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Cited by
Sorted by citations
Role of sperm chromatin abnormalities and DNA damage in male infertility.
Agarwal, A., & Said, T. (2003) · Human Reproduction Update · doi:10.1093/humupd/dmg027 · Cited by 889 · see citing works
“Environmental stress, gene mutations and chromosomal abnormalities can disturb the highly re®ned biochemical events that occur during spermatogenesis, and this can ultimately lead to an abnormal chromatin structure that is incompatible with fertility (Evenson et al., 2002).”
BackgroundRecurrent implantation failure: definition and management.
Coughlan, C., Ledger, W., Wang, Q., Liu, F.-H., Demirol, A., Gurgan, T., Cutting, R., Ong, K., Sallam, H., & Li, T.-C. (2014) · Reproductive Biomedicine Online · doi:10.1016/j.rbmo.2013.08.011 · Cited by 848 · see citing works
“The most extensively studied, sperm chromatin structure assay, measures the stability of sperm chromatin in acid media by measuring DNA susceptibility to denaturation following exposure to mild acid with acridine orange (Erenpreiss et al., 2006; Evenson, 1990; Evenson et al., 2002).”
BackgroundSperm DNA fragmentation: mechanisms of origin, impact on reproductive outcome, and analysis.
Sakkas, D., & Alvarez, J. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.10.046 · Cited by 734 · see citing works
Fernández, J. L., Muriel, L., Rivero, M. T., Goyanes, V. J., Vázquez, R., & Álvarez, J. G. (2003) · Journal of Andrology · doi:10.1002/j.1939-4640.2003.tb02641.x · Cited by 652 · see citing works
Virro, M., Larson-Cook, K. L., & Evenson, D. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.09.063 · Cited by 609 · see citing works
Self-citationDNA damage to spermatozoa has impacts on fertilization and pregnancy
Lewis, S., & Aitken, R. (2005) · Cell and Tissue Research · doi:10.1007/s00441-005-1097-5 · Cited by 532 · see citing works
“Of these, the Comet, TUNEL, and sperm chromatin structure assay (SCSA) (reviewed by Evenson et al. 2002; Agarwal and Said 2004) have been shown to have strong prognostic power in predicting successful treatment of male infertility.”
Fernández, J., Muriel, L., Goyanes, V., Segrelles, E., Gosálvez, J., Enciso, M., Lafromboise, M., & Jonge, C. D. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.11.089 · Cited by 478 · see citing works
“Main Outcome Measure(s): [1] The quality of chromatin staining in relaxed sperm nuclear halos and tail preservation; [2] SCD scoring reproducibility; [3] comparison with the sperm chromatin structure assay in 45 samples; [4] frequency of sperm with DNA fragmentation after incubation with increasing doses of the nitric…”
BackgroundMethodBungum, M., Humaidan, P., Spanô, M., Jepson, K., Bungum, L., & Giwercman, A. (2004) · Human Reproduction · doi:10.1093/humrep/deh280 · Cited by 472 · see citing works
“We have expressed the extent of DNA denaturation in terms of the DFI, which is the ratio of red to total (red plus green) ¯uorescence intensity, i.e. the level of denatured DNA over the total DNA (Evenson et al., 2002).”
BackgroundMethodResultInfluentialOxidative stress, DNA damage and apoptosis in male infertility: A clinical approach
Agarwal, A., & Said, T. M. (2005) · BJU International · doi:10.1111/j.1464-410x.2005.05328.x · Cited by 472 · see citing works
Saleh, R., Agarwal, A., Nada, E., El-Tonsy, M. H., Sharma, R., Meyer, A., Nelson, D., & Thomas, A. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00337-6 · Cited by 469 · see citing works
Moustafa, M. H., Sharma, R., Thornton, J., Mascha, E., Abdel-Hafez, M., Thomas, A., & Agarwal, A. (2004) · Human Reproduction · doi:10.1093/humrep/deh024 · Cited by 449 · see citing works
“Measurement of mature sperm nuclear DNA damage by SCSA DNA damage was measured in separate aliquots after a simple wash and density gradient centrifugation (fractions 1 and 2) by sperm chromatin structure assay (SCSA; Evenson et al., 1999, 2002).”
MethodWang, X., Sharma, R., Sikka, S., Thomas, A., Falcone, T., & Agarwal, A. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00756-8 · Cited by 424
“It is inappropriate to assume that DNA strand breaks are synonymous with apoptotic degradation (7).”
BackgroundSeli, E., Gardner, D., Schoolcraft, W., Moffatt, O. D., & Sakkas, D. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.12.039 · Cited by 420 · see citing works
Influence of deoxyribonucleic acid damage on fertilization and pregnancy.
Henkel, R., Hajimohammad, M., Stalf, T., Hoogendijk, C., Mehnert, C., Menkveld, R., Gips, H., Schill, W., & Kruger, T. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.09.044 · Cited by 409 · see citing works
Role of oxidative stress and antioxidants in andrology and assisted reproductive technology.
Sikka, S. (2004) · Journal of Andrology · doi:10.1002/j.1939-4640.2004.tb02751.x · Cited by 389 · see citing works
Wyrobek, A. J., Eskenazi, B., Young, S., Arnheim, N., Tiemann‐Boege, I., Jabs, E. W., Glaser, R. L., Pearson, F. S., & Evenson, D. P. (2006) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0506468103 · Cited by 402 · see citing works
Self-citationDo sperm DNA integrity tests predict pregnancy with in vitro fertilization?
Collins, J. A., Barnhart, K. T., & Schlegel, P. N. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.04.055 · Cited by 373 · see citing works
Sharma, R. K., Agarwal, A. K., Rohra, V. K., Assidi, M., Abu-Elmagd, M. M., & Turki, R. F. (2015) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-015-0028-x · Cited by 469 · see citing works
“sperm chromatin structure assay (SCSA) [74,75], or by the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay [76].”
MethodProtamine 2 Deficiency Leads to Sperm DNA Damage and Embryo Death in Mice1
Cho, C., Jung-Ha, H., Willis, W., Goulding, E., Stein, P., Xu, Z., Schultz, R., Hecht, N., & Eddy, E. (2003) · Biology of Reproduction · doi:10.1095/biolreprod.102.015115 · Cited by 363 · see citing works
“The defects in condensation of sperm chromatin seen in mice with heterozygous mutations in Prm1 and Prm2 [2] also occurred when a transgene-expressing avian protamine was expressed in spermatids [26]; in null mutations of Tp1 [19], Tp2 [20], and Csnk2a2 [27]; with suppression of Prm1 translation in MSY4 gain-of-functi…”
BackgroundClinical aspects of sperm DNA fragmentation detection and male infertility.
Evenson, D., & Wixon, R. (2006) · Theriogenology · doi:10.1016/j.theriogenology.2005.09.011 · Cited by 341
Self-citationTypes, Causes, Detection and Repair of DNA Fragmentation in Animal and Human Sperm Cells
Gonzalez-Marin, C., Gosálvez, J., & Roy, R. (2012) · International Journal of Molecular Sciences · doi:10.3390/ijms131114026 · Cited by 343 · see citing works
“In particular, the TUNEL assay quantifies the amount of cellular DNA breakage by incorporating fluorescent dNTPs at single- and double-stranded DNA ends in the presence of the enzyme terminal deoxynucleotidyl transferase while the SCSA method determines the extent of cellular DNA denaturation (induced by acids or heat…”
MethodInfluentialEvenson, D. (2016) · Animal Reproduction Science · doi:10.1016/j.anireprosci.2016.01.017 · Cited by 335 · see citing works
“Determination of the % HDS fraction has been useful to characterize sperm chromatin (protein) defects (Evenson et al., 2002b; Evenson et al., 1999a).”
InfluentialSelf-citationIncreased sperm DNA damage in patients with varicocele: relationship with seminal oxidative stress.
Smith, R., Kaune, H., Parodi, D. A., Madariaga, M., Ríos, R., Morales, I., & Castro, A. (2006) · Human Reproduction · doi:10.1093/humrep/dei429 · Cited by 332
“Sperm chromatin structure assay Sperm DNA damage was measured by SCSA following the procedure as described elsewhere (Evenson and Jost, 2000; Evenson et al., 2002).”
MethodEvaluation of nuclear DNA damage in spermatozoa from infertile men with varicocele.
Saleh, R., Agarwal, A., Sharma, R., Said, T., Sikka, S., & Thomas, A. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)02211-8 · Cited by 325
“, Westwood, MA) as described elsewhere (18).”
Håkonsen, L. B., Thulstrup, A. M., Aggerholm, A. S., Olsen, J., Bonde, J. P., Andersen, C. Y., Bungum, M., Ernst, E. H., Hansen, M. L., Ernst, E., et al. (2011) · Reproductive Health · doi:10.1186/1742-4755-8-24 · Cited by 334 · see citing works
“The details of this analysis have previously been described in detail [46,47].”
MethodAntioxidants to reduce sperm DNA fragmentation: an unexpected adverse effect.
Ménézo, Y., Hazout, A., Panteix, G., Robert, F., Rollet, J., Cohen-Bacrie, P., Chapuis, F., Clément, P., & Benkhalifa, M. (2007) · Reproductive Biomedicine Online · doi:10.1016/s1472-6483(10)60887-5 · Cited by 316 · see citing works
Lin, M.-H., Lee, R. K.-K., Li, S.-H., Lu, C.-H., Sun, F.-J., & Hwu, Y. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.06.018 · Cited by 309 · see citing works
Sperm DNA fragmentation: threshold value in male fertility
Sergerie, M., Laforest, G., Bujan, L., Bissonnette, F., & Bleau, G. (2005) · Human Reproduction · doi:10.1093/humrep/dei231 · Cited by 310 · see citing works
Rubes, J., Selevan, S., Evenson, D., Zudová, D., Vozdová, M., Zudová, Z., Robbins, W., & Perreault, S. (2005) · Human Reproduction · doi:10.1093/humrep/dei122 · Cited by 302 · see citing works
“Mean values for SCSA–%DFI were within the range associated with good fertility potential (Evenson et al., 1999, 2002) and values for total aneuploidy were within the range of those reported in the literature (reviewed by Shi and Martin, 2002).”
BackgroundMethodResultInfluentialSelf-citationAitken, R., Baker, M., & Sawyer, D. E. (2003) · Reproductive Biomedicine Online · doi:10.1016/s1472-6483(10)61730-0 · Cited by 302 · see citing works
“Human spermatozoa are unusual in that they frequently possess high levels of nuclear DNA damage that can be detected with a variety of methods, including modified nick translation methods, TUNEL (terminal deoxynucleotidyl transferase mediated dUTP nick end labelling), sperm chromatin stability assay (SCSA) and Comet a…”
MethodSperm function tests and fertility
Aitken, R. J. (2006) · International Journal of Andrology · doi:10.1111/j.1365-2605.2005.00630.x · Cited by 294 · see citing works
Full-term pregnancies achieved with ICSI despite high levels of sperm chromatin damage.
Gandini, L., Lombardo, F., Paoli, D., Caruso, F., Eleuteri, P., Leter, G., Ciriminna, R., Culasso, F., Dondero, F., Lenzi, A., et al. (2004) · Human Reproduction · doi:10.1093/humrep/deh233 · Cited by 291 · see citing works
“The categories proposed by Evenson et al. (2002) for individual fertility potential according to DFI fraction are: excellent <15%, good 15–24%, fair 25–30%, and poor >30% DFI, and if HDS is >15%, the fertility potential is downgraded at least one category, e.g. from excellent to good.”
BackgroundMethodInfluentialFatehi, A., Bevers, M., Schoevers, E., Roelen, B., Colenbrander, B., & Gadella, B. (2006) · Journal of Andrology · doi:10.2164/jandrol.04152 · Cited by 289 · see citing works
Sperm chromatin structure and male fertility: biological and clinical aspects.
Ērenpreiss, J., Spanô, M., Ērenpreisa, J., Bungum, M., & Giwercman, A. (2006) · Asian Journal of Andrology · doi:10.1111/j.1745-7262.2006.00112.x · Cited by 285 · see citing works
Marcon, L., & Boissonneault, G. (2004) · Biology of Reproduction · doi:10.1095/biolreprod.103.022541 · Cited by 281 · see citing works
“Not surprisingly, the predictive value of sperm chromatin integrity for pregnancy outcome has been demonstrated and emerges as a new sperm parameter in the clinical setting [6, 7].”
BackgroundIncreased sperm nuclear DNA damage in normozoospermic infertile men: a prospective study.
Saleh, R., Agarwal, A., Nelson, D., Nada, E., El-Tonsy, M. H., Alvarez, J., Thomas, A., & Sharma, R. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03219-3 · Cited by 275 · see citing works
“The %DFI [median (25th and 75th percentiles)] in infertile men with normal sperm parameters [23 (15, 32)] was significantly higher than fertile donors [15 (11, 20)] (P .”
BackgroundFlow cytometric sexing of mammalian sperm.
Garner, D. L. (2006) · Theriogenology · doi:10.1016/j.theriogenology.2005.09.009 · Cited by 274
Lewis, S. E. M., Aitken, R. J., Conner, S. J., Iuliis, G. N. D., Evenson, D. P., Henkel, R., Giwercman, A., & Gharagozloo, P. (2013) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2013.06.014 · Cited by 285 · see citing works
“The software SCSAsoft computes the raw red versus green fluorescence data as red/red + green fluorescence (Evenson et al., 2002).”
MethodSelf-citationSaleh, R. A., Agarwal, A., Kandirali, E., Sharma, R. K., Thomas, A. J., Nada, E. A., Evenson, D. P., & Alvarez, J. G. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)04237-1 · Cited by 259 · see citing works
Self-citationUnexplained male infertility: diagnosis and management.
Hamada, A., Esteves, S., Nizza, M., & Agarwal, A. (2012) · International Brazilian Journal of Urology · doi:10.1590/s1677-55382012000500002 · Cited by 253 · see citing works
“Several studies report a cut off value greater than 30% in DFI has shown to be associated with significant decreases in IVF fertilization as well as clinical pregnancy rates, with dramatically higher rates of success below the cut off (72,120,121).”
BackgroundSperm DNA damage in male infertility: etiologies, assays, and outcomes
Schulte, R. T., Ohl, D. A., Sigman, M., & Smith, G. D. (2009) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-009-9359-x · Cited by 260 · see citing works
“Environmental stress, gene mutations, and chromosomal abnormalities can all disturb biochemical events that occur during spermatogenesis, which can ultimately lead to abnormal chromatin structure incompatible with fertility [41].”
BackgroundDNA integrity is compromised in protamine-deficient human sperm.
Aoki, V., Moskovtsev, S., Willis, J., Liu, L., Mullen, J., & Carrell, D. (2005) · Journal of Andrology · doi:10.2164/jandrol.05063 · Cited by 248 · see citing works
Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations
Esteves, S., Zini, A., Coward, R., Evenson, D., Gosálvez, J., Lewis, S., Sharma, R., & Humaidan, P. (2020) · Andrologia · doi:10.1111/and.13874 · Cited by 246 · see citing works
“The ‘iceberg effect’ hypothesis was initially proposed by Evenson (Evenson et al., 2002) and Alvarez (Alvarez, 2005) and elaborated further by Gosálvez (Gosálvez et al., 2013).”
BackgroundSelf-citationImpact of a mild scrotal heat stress on DNA integrity in murine spermatozoa.
Banks, S., King, S., Irvine, D., & Saunders, P. (2005) · Reproduction · doi:10.1530/rep.1.00531 · Cited by 242 · see citing works
“This assay is considered to give a measure both of what proportion of spermatozoa contain incorrect packaged/remodeled DNA as well as the prevalence of DNA strand breaks, as both situations will result in DNA more susceptible to acid denaturation (Larson et al. 2000, Evenson et al. 2002).”
BackgroundCocuzza, M., Sikka, S. C., Athayde, K. S., & Agarwal, A. K. (2007) · International braz j urol · doi:10.1590/s1677-55382007000500002 · Cited by 236 · see citing works
“Bungum et al. reported that for IUI, there was a significantly higher chance of pregnancy/ delivery in the group with DFI < 27% and HDS (highly DNA stainable) of < 10% than in patients with DFI > 27% and HDS > 10%.”
BackgroundInfluentialRibas-Maynou, J., García-Peiró, A., Fernández-Encinas, A., Abad, C., Amengual, M., Prada, E., Navarro, J., & Benet, J. (2013) · Andrology · doi:10.1111/j.2047-2927.2013.00111.x · Cited by 229 · see citing works
Oxidative stress and alterations in DNA methylation: two sides of the same coin in reproduction
Menezo, Y. J. R., Silvestris, E., Dale, B., & Elder, K. T. (2016) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2016.09.006 · Cited by 247 · see citing works
Oxidative stress and medical antioxidant treatment in male infertility.
Lanzafame, F., la Vignera, S., Vicari, E., & Calogero, A. (2009) · Reproductive Biomedicine Online · doi:10.1016/j.rbmo.2009.09.014 · Cited by 224 · see citing works
“This implies that spermatozoa with damaged DNA are able to fertilize oocytes, but at the time when the paternal genome is switched on, further development stops (Evenson et al., 2002).”
BackgroundGiwercman, A., Lindstedt, L., Larsson, M., Bungum, M., Spanô, M., Levine, R., & Rylander, L. (2010) · International Journal of Andrology · doi:10.1111/j.1365-2605.2009.00995.x · Cited by 223
Clinical significance of sperm DNA damage in assisted reproduction outcome
Simon, L., Brunborg, G., Stevenson, M., Lutton, D., McManus, J., & Lewis, S. E. M. (2010) · Human Reproduction · doi:10.1093/humrep/deq103 · Cited by 236 · see citing works
“Of these, the Comet assay under alkaline and neutral conditions, TUNEL assay and SCSA (reviewed by Evenson et al ., 2002; Agarwal and Said, 2003) have been shown to be most robust.”
MethodSperm Chromatin Structure Assay (SCSA®)
Evenson, D. P. (2012) · Methods in molecular biology · doi:10.1007/978-1-62703-038-0_14 · Cited by 222 · see citing works
Self-citationCorrelation between sperm motility and sperm chromatin structure assay parameters.
Giwercman, A., Richthoff, J., Hjøllund, H., Bonde, J., Jepson, K., Frohm, B., & Spanô, M. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)02212-x · Cited by 215 · see citing works
Smit, M., Romijn, J., Wildhagen, M., Veldhoven, J. L. M., Weber, R., & Dohle, G. (2013) · Journal of Urology · doi:10.1016/j.juro.2012.11.024 · Cited by 215
Sperm DNA damage assessment: a test whose time has come.
Agarwal, A., & Allamaneni, S. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.03.080 · Cited by 214
“ultiple techniques can measure DNA defects in human permatozoa (3, 7).”
BackgroundSteiner, A. Z., Hansen, K. R., Barnhart, K. T., Cedars, M. I., Legro, R. S., Diamond, M. P., Krawetz, S. A., Usadi, R., Baker, V. L., Coward, R. M., et al. (2020) · Fertility and Sterility · doi:10.1016/j.fertnstert.2019.11.008 · Cited by 213 · see citing works
“In addition, 1 mL of semen was stored at 80 C and subsequently shipped frozen to the Utah Andrology Laboratory for DNA fragmentation assessment using the sperm chromatin structure analysis (SCSA) test (14), when 10 million sperm were present.”
MethodThe relationship between male BMI and waist circumference on semen quality: data from the LIFE study
Eisenberg, M. L., Kim, S., Chen, Z., Sundaram, R., Schisterman, E. F., & Louis, G. M. B. (2013) · Human Reproduction · doi:10.1093/humrep/det428 · Cited by 342 · see citing works
Oxidative DNA damage in human sperm influences time to pregnancy.
Loft, S., Kold-Jensen, T., Hjollund, N. H., Giwercman, A., Gyllemborg, J., Ernst, E., Olsen, J., Scheike, T., Poulsen, H., & Bonde, J. (2003) · Human Reproduction · doi:10.1093/humrep/deg202 · Cited by 212 · see citing works
Probes and Techniques for Sperm Evaluation by Flow Cytometry
Martínez‐Pastor, F., Mata-Campuzano, M., Álvarez‐Rodríguez, M., Alvarez, M., Anel, L., & de Paz, P. (2010) · Reproduction in Domestic Animals · doi:10.1111/j.1439-0531.2010.01622.x · Cited by 206 · see citing works
Effect of sperm DNA fragmentation on pregnancy outcome depends on oocyte quality.
Meseguer, M., Santiso, R., Garrido, N., García-Herrero, S., Remohi, J., & Fernández, J. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2010.05.055 · Cited by 207 · see citing works
Sperm chromatin structure assay (SCSA): a tool in diagnosis and treatment of infertility.
Bungum, M., Bungum, L., & Giwercman, A. (2011) · Asian Journal of Andrology · doi:10.1038/aja.2010.73 · Cited by 205 · see citing works
Ford, W. (2010) · Asian Journal of Andrology · doi:10.1038/aja.2008.57 · Cited by 197 · see citing works
Adverse effect of paroxetine on sperm.
Tanrikut, C., Feldman, A., Altemus, M., Paduch, D., & Schlegel, P. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2009.04.039 · Cited by 194 · see citing works
The sperm chromatin structure assay as a diagnostic tool in the human fertility clinic.
Boe-Hansen, G., Fedder, J., Ersbøll, A., & Christensen, P. (2006) · Human Reproduction · doi:10.1093/humrep/del019 · Cited by 190 · see citing works
“Evenson and coworkers (1980) described the sperm chromatin structure assay (SCSA) in the early 1980s, and the assay has since been refined (Evenson et al., 2002) and used for both animal and human semen (Evenson, 1999).”
BackgroundMethodInfluentialHigh-power microscopy for selecting spermatozoa for ICSI by physiological status.
Garolla, A., Fortini, D., Menegazzo, M., Toni, L. D., Nicoletti, V., Moretti, A., Selice, R., Engl, B., & Foresta, C. (2008) · Reproductive Biomedicine Online · doi:10.1016/s1472-6483(10)60307-0 · Cited by 181
“Again, the determination of sperm DNA damage (i.e. DNA fragmentation and abnormal DNA integrity) is strongly recommended when advanced forms of assisted reproductive techniques are used (Barroso et al., 2000; Evenson et al., 2002; Zini et al., 2006).”
MethodMale accessory gland infection and sperm parameters (review)
Vignera, S. L., Vicari, E. S. D., Condorelli, R. A., D’Agata, R., & Calogero, A. E. (2011) · International Journal of Andrology · doi:10.1111/j.1365-2605.2011.01200.x · Cited by 189 · see citing works
Louis, G. M. B., Sundaram, R., Schisterman, E. F., Sweeney, A., Lynch, C. D.-J., Kim, S., Maisog, J. M., Gore‐Langton, R. E., Eisenberg, M. L., & Chen, Z. (2013) · Fertility and Sterility · doi:10.1016/j.fertnstert.2013.10.022 · Cited by 198 · see citing works
Shamsi, M. B., Imam, S., & Dada, R. (2011) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-011-9631-8 · Cited by 173 · see citing works
“The alkaline comet assay cannot differentiate between single or double strand breaks, endogenous or induced breaks and moreover the alkali labile sites are not considered specific for infertility [106, 107].”
BackgroundHond, E. D. D., Tournaye, H., Sutter, P. D., Ombelet, W., Baeyens, W., Covaci, A., Cox, B., Nawrot, T., van Larebeke, N., & D'Hooghe, T. (2015) · Environment International · doi:10.1016/j.envint.2015.07.017 · Cited by 170 · see citing works
“DNA fragmentation in sperm (Evenson et al., 2002) would allow a more mechanistic approach and hence be an added value to the study.”
BackgroundCorrelation between DNA damage and sperm parameters: a prospective study of 1,633 patients.
Cohen-Bacrie, P., Belloc, S., Ménézo, Y. J. R., Clement, P., Hamidi, J., & Benkhalifa, M. (2009) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.01.086 · Cited by 170 · see citing works
“It generally is admitted that the relation between fragmentation and World Health Organization sperm parameters is weak (1).”
BackgroundEffects of environmental and occupational pesticide exposure on human sperm: a systematic review
Perry, M. J. (2008) · Human Reproduction Update · doi:10.1093/humupd/dmm039 · Cited by 224 · see citing works
“The integrity of sperm DNA is central to the transmission of genetic information during reproduction and chromatin abnormalities or DNA damage can result in paternal fertility problems (Evenson et al., 2002; Agarwal and Said, 2003).”
Rapid selection of sperm with high DNA integrity.
Nosrati, R., Vollmer, M., Eamer, L., San-Gabriel, M., Zeidan, K., Zini, A., & Sinton, D. (2014) · Lab on a Chip · doi:10.1039/c3lc51254a · Cited by 159
Clinical relevance of sperm DNA damage in assisted reproduction.
Tarozzi, N., Bizzaro, D., Flamigni, C., & Borini, A. (2007) · Reproductive Biomedicine Online · doi:10.1016/s1472-6483(10)60678-5 · Cited by 159 · see citing works
“Furthermore, several clinical studies have shown its usefulness in evaluating male fertility (Evenson et al., 2002; Larson et al., 2000; Spano et al., 2000; Bungum et al., 2004; Virro et al., 2004).”
BackgroundMethodThe Effect of Ambient Air Pollution on Sperm Quality
Hansen, C. A., Luben, T. J., Sacks, J. D., Olshan, A. F., Jeffay, S. C., Strader, L. F., & Perreault, S. D. (2009) · Environmental Health Perspectives · doi:10.1289/ehp.0901022 · Cited by 164 · see citing works
The relationship between human sperm apoptosis, morphology and the sperm deformity index
Aziz, N., Said, T. M., Paasch, U., & Agarwal, A. K. (2007) · Human Reproduction · doi:10.1093/humrep/dem016 · Cited by 147 · see citing works
“Activated caspase-3, loss of the integrity of the mitochondrial membrane potential (MMP) and DNA fragmentation are other markers of terminal apoptosis expressed by a varying proportions of ejaculated sperm (Evenson et al., 2002; Paasch et al., 2004a,b).”
Spontaneous DNA fragmentation in swim-up selected human spermatozoa during long term incubation.
Muratori, M., Maggi, M., Spinelli, S., Filimberti, E., Forti, G., & Baldi, E. (2003) · Journal of Andrology · doi:10.1002/j.1939-4640.2003.tb02670.x · Cited by 154
“Emerging findings show that sperm DNA/chromatin integrity is required for optimum fertility success (Evenson et al, 2002).”
Spano, M., Toft, G. V., Hagmar, L., Eleuteri, P., Rescia, M., Rignell‐Hydbom, A., Tyrkiel, E. J., Zvyezday, V., & Bonde, J. P. (2005) · Human Reproduction · doi:10.1093/humrep/dei297 · Cited by 149 · see citing works
“Sperm DNA integrity can effectively be evaluated by the sperm chromatin structure assay (SCSA) (Evenson et al., 2002; Perreault et al., 2003), which measures, by flow cytometry, the susceptibility of sperm nuclear DNA to denaturation in situ followed by Acridine Orange staining (Evenson et al.,…”
BackgroundMethodInfluentialAbsence of sperm RNA elements correlates with idiopathic male infertility
Jodar, M., Sendler, E. D., Moskovtsev, S. I., Librach, C. L., Goodrich, R. J., Swanson, S., Hauser, R. B., Diamond, M. P., & Krawetz, S. A. (2015) · Science Translational Medicine · doi:10.1126/scitranslmed.aab1287 · Cited by 166 · see citing works
Fertility estimation: a review of past experience and future prospects.
Foote, R. (2003) · Animal Reproduction Science · doi:10.1016/s0378-4320(02)00233-6 · Cited by 151
The effects of sperm quality on embryo development after intracytoplasmic sperm injection
Loutradi, K., Tarlatzis, B., Goulis, D., Zepiridis, L., Pagou, T., Chatziioannou, E., Grimbizis, G., Papadimas, I., & Bontis, I. (2006) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-006-9022-8 · Cited by 147
“It has been reported that ejaculated sperm can exhibit DNA strand breaks (fragmentation) due to underprotamination during spermiogenesis (16,17).”
How do male germ cells handle DNA damage?
Olsen, A.-K. H., Lindeman, B., Wiger, R., Duale, N., & Brunborg, G. (2005) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2005.01.060 · Cited by 136 · see citing works
Ērenpreiss, J., Jepson, K., Giwercman, A., Tsarev, I., Erenpreisa, J., & Spanô, M. (2004) · Human Reproduction · doi:10.1093/humrep/deh417 · Cited by 142
“HDS is thought to be indicative of immature sperm cells in which the chromatin might be less compact and more accessible to nuclear dyes (Evenson et al., 2002).”
InfluentialBorges, E., Zanetti, B. F., Setti, A., Braga, D. P. D. A. F., Provenza, R., & Iaconelli, A. (2019) · Fertility and Sterility · doi:10.1016/j.fertnstert.2019.04.029 · Cited by 140
Sperm DNA Tests as Useful Adjuncts to Semen Analysis
Lewis, S. E. M., Agbaje, I., & Álvarez, J. G. (2008) · Systems Biology in Reproductive Medicine · doi:10.1080/19396360801957739 · Cited by 137 · see citing works
“Of these, the COMET, terminal deoxynucleotidyl transferase (TdT, TUNEL) and Sperm Chromatin Structure assays (reviewed by [Evenson et al. 2002; Agarwal and Said 2004; Lewis and Aitken 2005]) have been shown to be the most informative.”
MethodMoskovtsev, S. I., Willis, J., & Mullen, J. B. M. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2005.05.075 · Cited by 147 · see citing works
Belloc, S., Cohen-Bacrie, P., Benkhalifa, M., Cohen-Bacrie, M., de Mouzon, J., Hazout, A., & Ménézo, Y. (2008) · Reproductive Biomedicine Online · doi:10.1016/s1472-6483(10)60223-4 · Cited by 138 · see citing works
“Progress in the analysis of sperm DNA structure has clearly demonstrated that sperm DNA fragmentation increases with age, with or without oxidative stress as an additional factor (Duran et al., 2002; Evenson et al., 2002; Aitken et al., 2003; Guérin et al., 2005; Evenson and Wixon, 2006).”
BackgroundICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment
Greco, E., Romano, S., Iacobelli, M., Ferrero, S., Baroni, E., Minasi, M., Ubaldi, F., Rienzi, L., & Tesarik, J. (2005) · Human Reproduction · doi:10.1093/humrep/dei091 · Cited by 136 · see citing works
Fall in implantation rates following ICSI with sperm with high DNA fragmentation.
Speyer, B., Pizzey, A., Ranieri, M., Joshi, R., Delhanty, J., & Serhal, P. (2010) · Human Reproduction · doi:10.1093/humrep/deq116 · Cited by 134
“The in-house SCSA assay followed the procedure previously described elsewhere (Evenson and Jost, 1994; Evenson et al., 2002).”
MethodRibas-Maynou, J., García-Peiró, A., Fernández-Encinas, A., Amengual, M., Prada, E., Cortés, P., Navarro, J., & Benet, J. (2012) · PLoS ONE · doi:10.1371/journal.pone.0044679 · Cited by 133 · see citing works
Muratori, M., Tarozzi, N., Carpentiero, F., Danti, S., Perrone, F., Cambi, M., Casini, A., Azzari, C., Boni, L., Maggi, M., et al. (2019) · Scientific Reports · doi:10.1038/s41598-019-43981-2 · Cited by 131 · see citing works
Ménézo, Y., Russo, G., Tosti, E., El-Mouatassim, S., & Benkhalifa, M. (2007) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-007-9167-0 · Cited by 131 · see citing works
“On the other hand, paternal DNA always carries a varying level of DNA strand breaks [1–10].”
BackgroundMethodRadwan, M., Jurewicz, J., Polańska, K., Sobala, W., Radwan, P., Bochenek, M., & Hanke, W. (2015) · Annals of Human Biology · doi:10.3109/03014460.2015.1013986 · Cited by 146 · see citing works
“High DNA stainability (%HDS) was calculated on the basis of the percentage of sperm with high levels of green fluorescence, which are thought to represent immature spermatozoa with incomplete chromatin condensation (Evenson et al., 2002).”
MethodInfluence of the abstinence period on human sperm quality.
Jonge, C. D., Lafromboise, M., Bosmans, E., Ombelet, W., Cox, A., & Nijs, M. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.03.014 · Cited by 130 · see citing works
Review: Diagnosis and impact of sperm DNA alterations in assisted reproduction.
Simon, L., Emery, B., & Carrell, D. (2017) · Best Practice & Research: Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2017.07.003 · Cited by 129 · see citing works
O'Flaherty, C., Vaisheva, F., Hales, B., Chan, P., & Robaire, B. (2008) · Human Reproduction · doi:10.1093/humrep/den081 · Cited by 127
“To assess the susceptibility of sperm DNA to acid-induced denaturation, the SCSA was done using a method described previously (Evenson et al., 2002).”
MethodRubes, J., Selevan, S., Sram, R., Evenson, D., & Perreault, S. (2007) · Mutation research · doi:10.1016/j.mrfmmm.2007.05.012 · Cited by 127
Self-citationUpdate on semen technologies for animal breeding.
Morrell, J. (2006) · Reproduction in domestic animals = Zuchthygiene · doi:10.1111/j.1439-0531.2006.00621.x · Cited by 127
ICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment.
Greco, E., Romano, S., Iacobelli, M., Ferrero, S., Baroni, E., Minasi, M., Ubaldi, F., Rienzi, L., & Tesarik, J. (2006) · Human Reproduction · doi:10.1016/s0022-5347(05)00440-4 · Cited by 126
“This phenomenon has previously been described for SCSA data and termed the 'tip of the iceberg' effect (Evenson et al., 2002).”
MethodEffect of sperm DNA fragmentation on embryo development: clinical and biological aspects
Sedó, C. A., Bilinski, M., Lorenzi, D., Uriondo, H., Noblía, F., Longobucco, V., Lagar, E. V., & Nodar, F. (2017) · JBRA Assisted Reproduction · doi:10.5935/1518-0557.20170061 · Cited by 125 · see citing works
“DNA damage may have a negative impact in IVFICSI results (Evenson et al., 2002; Cordelli et al., 2005; Sergerie et al., 2005; Greco et al., 2005; Boe-Hansen et al., 2006; Makhlouf & Niederberger, 2006; Avendaño et al., 2009a; Avendaño et al., 2009b; Góngora-Rodríguez & Fontanilla-Ramírez, 2010;…”
BackgroundIntegrating new tests of sperm genetic integrity into semen analysis: breakout group discussion.
Perreault, S. D., Aitken, R., Baker, H. W. G., Evenson, D., Huszar, G., Irvine, D., Morris, I. D., Morris, R. A., Robbins, W., Sakkas, D., et al. (2003) · Advances in Experimental Medicine and Biology · doi:10.1007/978-1-4419-9190-4_23 · Cited by 125
Self-citationThe sperm cell : production, maturation, fertilization, regeneration
O'Hara, L., Smith, L., Jonge, C. D., & Barratt, C. (2017) · doi:10.1017/9781316411124 · Cited by 124
- Authors
- EVENSON, D. P., LARSON, K. L., & JOST, L. K.
- Affiliations
- South Dakota State University (US)
- Corresponding author
- EVENSON, DONALD P.
- ORCID
- EVENSON, DONALD P.
- Venue
- Journal of Andrology
- Publisher
- Wiley
- Published
- 2002-01-02
- Volume
- 23
- Issue
- 1
- Pages
- 25-43
- ISSN
- 0196-3635 (ISSN-L)
- 1939-4640
- OpenAlex
- W1532901402
- Cited by
- 1,072
- References
- 158
- Citations by year
- 2026: 15 · 2025: 21 · 2024: 18 · 2023: 25 · 2022: 36 · 2021: 59 · 2020: 35 · 2019: 50 · 2018: 49 · 2017: 51 · 2016: 42 · 2015: 53 · 2014: 53 · 2013: 68 · 2012: 61
- FWCI
- 38.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Andrology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation (9452894, 9720642)
- U.S. Environmental Protection Agency
- South Dakota Agricultural Experiment Station
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Physiology › Reproductive biology and impacts on aquatic species
- Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
- Keywords
- sperm chromatin structure assay, sperm DNA fragmentation, male infertility, testicular cancer
- MeSH terms
- Chromatin, Humans, Infertility, Male, Male, Spermatozoa, DNA Fragmentation
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