INTRODUCTION

1.1 Background Information

Chlamydia trachomatis (CT) is one of the most frequently sexually transmitted infection (STI) in human beings and occurs more in partners who are sexually active. Annually, roughly about 100 million upcoming cases of CT are treated in the world. The spread of CT is highly favored because it is asymptomatic, with an infection rate of about 50% men and 90% women. The research of CT is currently focused on females abandoning males despite the statistics that its frequency of infection is similar to both (Jenniffer et al. 2017).

Clinicians and researchers in the discipline of reproductive medicine have raised a concern about the spread of STIs. Research shows that almost about 15% of infertility in men is associated with infection of the genital tract. The part played by CT infections towards infertility in males is disputable. Some researches relate CT to inferior semen quality. In contrast, others indicate that CT is characterized by a reduction in sperm motility and concentration, a drop in the number of sperms ejaculated, and interference with the semen pH (Hanen et al. 2014). Infection with CT causes epididymitis, urethritis, and prostatitis in men. Infertility may be caused by the swelling of the epididymis due to the obstruction of the sperm tract (Band et al. 2018).

Sperm DNA fragmentation (SDF) is caused by aging, diseases, lifestyle-related actions, and body infections. It poses a danger towards reproduction in humans and the health of the infants. SDF is induced by three main factors; apoptosis, oxidative stress, and defects in the maturation of sperm chromatin. Apoptosis and sperm chromatin impairment affects testis and causes breaks in the DNA, resulting in dead spermatozoa. Oxidative stress induces SDF after the ejaculation of sperms (Monica et al. 2019).

SDF has become essential in clinics in the essence of its outcome in assisted reproductive technology (Luca et al. 2019). In most semen analysis, DNA quality in sperm cells is not assessed because of sophisticated and complex technologies for DNA evaluation. The standard technology used is sperm chromatin structure assay (SCSA), used in evaluating the damage in sperm DNA (Fernandez et al. 2015). Research has shown that people presenting high levels of SDF are linked to the unsuccessful production of children than individuals expressing low rates of SDF (Fernandez et al. 2015).

Figure 1: Factors impacting the level of SDF present in a semen sample

2152650126365Fertilization Strategy

Fertilization Strategy

4676775230314529718002284095114300022936204743450150304510477501522095292290542672021621753808095Oocyte DNA Repair Capacity

0Oocyte DNA Repair Capacity

right2722245Iatrogenic Sperm Damage

00Iatrogenic Sperm Damage

4381502722245Patient Characteristics

0Patient Characteristics

right1893570SDF and Reproductive Outcome

SDF and Reproductive Outcome

342900798195Techniques for Sperm Selection

0Techniques for Sperm Selection

3752850798195Values for SDF Obtained on Neat or Selected Samples

0Values for SDF Obtained on Neat or Selected Samples

Source: Fernandez et al. 2015