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The miracle of conception – how we all got to be here Successful conception requires spermatozoa to exhibit a wide range of sophisticated behaviours and biochemical changes. They are capable of exhibiting rheotaxis, thermotaxis and chemotaxis on their voyage to the site of fertilization in the oviduct. Once these cells have successfully engaged the cervix and uterotubal junction they come to rest in the isthmic region of the Fallopian tubes, where they are thought to bind to the oviductal epithelium and enter a state of quiescence. They are ultimately awakened from this gentle slumber by a signal coincident with ovulation and break away from the isthmic epithelium in a frenzied state of hyperactivation. These hyperactivated cells then bring their receptors-for-the-egg to the cell surface and go in search of their prey, aided by signals given out by the egg bearing a come-hither message. At this point in development, it is a race to find the fittest spermatozoa capable of engaging in the myriad cellular interactions required to achieve fertilization. It is a race that only one cell can win out of the ~200 million that started the race. Each one of us is the result of an incredibly complex obstacle race where all of the other competitors died.
This chapter discusses the four important measurable aspects of sperm function that define a good sperm: sperm transport, sperm-epithelial contact, sperm-egg recognition and fertilisation, and DNA quality. One of the important aspects of sperm transport to emerge over the past ten years is the role of sperm-epithelial contact in regulating sperm physiology during the preovulatory period. It has been shown that co-culture of sperm with epithelium from the human endosalpinx prolongs sperm viability, increases motility and delays the process of sperm capacitation. Whether fertilisation occurs in vitro or in vivo, it is almost certain that the cellular and molecular processes of sperm-egg recognition and fertilisation are identical. Studies of sperm DNA quality have shown that DNA integrity is directly related to the probability of conception, both in the general population and in couples attending for assisted conception treatment.
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