How Well Do Semen Analysis Parameters Correlate with Sperm DNA Fragmentation? A Retrospective Study from 2567 Semen Samples Analyzed by the Halosperm Test

Abstract

Sperm DNA fragmentation (SDF) levels have been measured in the workup for in vitro fertilization (IVF) at PIVET since 2007, with the Halosperm test having replaced the previous sperm chromatin structure assay (SCSA) since 2013. Of 2624 semen samples analyzed for the Halosperm test, 57 were excluded as the sperm concentration was <5 million/mL, a level too low for accurate testing, leaving 2567 samples for assessment within this study. The SDF rates were categorized in 5 sperm DNA fragmentation indices (DFI), ranging from <5% to levels >30%, and these categories were correlated with the respective semen analysis profiles and two clinical parameters, namely the age of the male and the ejaculatory abstinence period prior to the sample. The results showed a significant correlation with male age (r = 0.088; p < 0.0001), the abstinence period (r = 0.076; p = 0.0001), and the semen volume (r 0.063; p = 0.001), meaning an adversely high SDF was associated with advanced age, prolonged abstinence, and raised semen volume parameters. There was a significant negative correlation with sperm morphology (r = −0.074; p = 0.0001), progressive motility (r = −0.257; p < 0.0001), and semen pH (r = −0.066; p < 0.001), meaning these semen anomalies were associated with high SDF values. With respect to abnormal morphology, sperm tail defects had a positive correlation (r = 0.096; p < 0.0001) while midpiece defects showed a negative correlation (r = −0.057; p = 0.004), meaning that tail defects are most likely to associate with adverse DFI values. With respect to motility patterns, the poorer patterns showed a positive correlation with increased DFI, namely C pattern (r = 0.055; p = 0.005) and D pattern (r = 0.253; p < 0.0001). These results imply that raised DFI reflects poor sperm quality and should be investigated in clinical trials involving IVF and the consideration of intracytoplasmic sperm injection (ICSI).

Male Clinical Parameters (Age, Stature, Weight, Body Mass Index, Smoking History, Alcohol Consumption) Bear Minimal Relationship to the Level of Sperm DNA Fragmentation

“…Aging was observed to have a direct correlation with SDF in our study, which is consistent with a cross-sectional study that included semen samples from 2178 men and our previous study [ 36 , 69 ]. Aging is associated with both damage to the DNA of the nucleus and of the mitochondria, as well as a decrease in sperm motility, which are mainly caused by oxidative stress from ROS [ 69 ].…”

“…The Halosperm test was conducted on 2624 men attending PIVET Medical Centre (PIVET) between 1 March 2013 and 30 September 2022, the details of which have been fully described in an earlier publication [ 36 ], which examined DNA fragmentation index (DFI) and its correlation with semen analysis profiles. This retrospective study was conducted on 1291 of those men who were the partners (husbands and de facto husbands) of women presenting with infertility who also had stature (height), weight, and BMI measurements recorded, along with age recorded at the time of the test.…”

“…Our previous report has described the principle of the Halosperm test [ 36 ]. It is based on a controlled DNA denaturation process to facilitate the subsequent removal of the proteins contained in each spermatozoa.…”

Unraveling the Impact of Sperm DNA Fragmentation on Reproductive Outcomes

“…The precise relationship between SDF and conventional semen parameters is still a subject of debate. However, some studies suggest a significant inverse relationship between SDF and factors like motility, 54,55 sperm concentration, 56,57 and morphology, 58,59 either individually or in combination. In contrast, other studies do not report such a relationship.…”

Abnormality Determination of Spermatozoa Motility Using Gaussian Mixture Model and Matching-based Algorithm

“…Microscopic examination in sperm analysis includes morphological analysis that is based on size, involving head length, head width, mid-piece, and tail length [21] [22]. However, the size of spermatozoa is not an absolute requirement for determining normal and abnormal spermatozoa [23] [24].…”