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Sperm Chromatin Structure Assay (SCSA®): Evolution from Origin to Clinical Utility

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A Clinician's Guide to Sperm DNA and Chromatin Damage

Abstract

The pioneering sperm DNA fragmentation assay, the Sperm Chromatin Structure Assay (SCSA®), was invented in 1980. However, prior to using it in human fertility clinics, numerous experiments were done to standardize and validate the assay regarding biochemistry, stability, repeatability, significant correlations with animal fertility, and standardization between SCSA measures done on different continents in independent laboratories. From international studies, it is concluded that the SCSA is a rapid, technician-friendly, statistically robust test on 5000 sperm /sample with good predictive value for in vivo, IUI, IVF, or ICSI reproductive outcomes. The SCSA test uniquely measures two distinct populations of sperm, namely, those with sperm DNA strand breaks (%DFI) and sperm with uncondensed chromatin (%HDS: high DNA stainability). High levels of HDS sperm lead to cessation of early embryo development. Even though the exact cause and origin of sperm DNA/chromatin damage remain unknown, the established SCSA thresholds for in vivo, IUI, IVF, and ICSI success strongly support an increasingly routine use in the urology and infertility clinics.

Normal semen samples according to WHO criteria with 0–20% SCSA-defined DFI are consistent with excellent odds for in vivo or IUI conception; decreasing odds occur with 20–30% DFI at which point in vivo and IUI have very poor odds and ICSI is recommended. At >40% DFI, the odds are low for pregnancy and high for miscarriage. A >30–40% HDS leads to early cessation of embryo development. Lifestyle and medical intervention may reduce the %DFI and % HDS to better odds for a successful pregnancy.

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Author information

Authors and Affiliations

  1. SCSA Diagnostics, Inc., Brookings, SD, USA

    Donald P. Evenson

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  1. Donald P. Evenson
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Correspondence to Donald P. Evenson .

Editor information

Editors and Affiliations

  1. Department of Surgery, Division of Urology, McGill University, Montreal, Québec, Canada

    Armand Zini

  2. American Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA

    Ashok Agarwal

Additional information

This chapter is dedicated to the memory of Marcello Spano who died of a fatal heart attack in his ENEA lab in Rome, December, 2016. In 1979, Marcello invited me to his lab to set up the SCSA test. In 2000, he published a seminal paper, Sperm Chromatin Damage Impairs Human Fertility. The Danish First Pregnancy Planner Study Team. Fertil. Steril. 73:43-50. His frequent collaboration with Aleksander Giwercman and Mona Bungum in Sweden brought a wealth of valuable SCSA clinical data on sperm DNA fragmentation as related to male factor infertility. We are grateful for his excellent collaboration and warm friendship; he will be greatly missed.

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Evenson, D.P. (2018). Sperm Chromatin Structure Assay (SCSA®): Evolution from Origin to Clinical Utility. In: Zini, A., Agarwal, A. (eds) A Clinician's Guide to Sperm DNA and Chromatin Damage. Springer, Cham. https://doi.org/10.1007/978-3-319-71815-6_4

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  • DOI: https://doi.org/10.1007/978-3-319-71815-6_4

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