Sperm deoxyribonucleic acid fragmentation (by terminal deoxynucleotidyl transferase biotin dUTP nick end labeling assay) does not impair reproductive success measured as cumulative live birth rates per donor metaphase II oocyte used

Sperm DNA Damage and Its Relevance in Fertility Treatment: A Review of Recent Literature and Current Practice Guidelines

“…While the precise mechanism(s) behind these results remains under investigation, these findings support the hypothesis that higher-quality oocytes likely have better DNA repair capabilities, allowing them to compensate for sperm DNA damage and produce higher-quality embryos that can develop normally [ 42 ]. However, even if this theory is correct, current evidence does not suggest what degree of SDF is too high for an oocyte to overcome [ 42 ].…”

“…While the precise mechanism(s) behind these results remains under investigation, these findings support the hypothesis that higher-quality oocytes likely have better DNA repair capabilities, allowing them to compensate for sperm DNA damage and produce higher-quality embryos that can develop normally [ 42 ]. However, even if this theory is correct, current evidence does not suggest what degree of SDF is too high for an oocyte to overcome [ 42 ]. Additionally, the sperm selection process associated with ICSI itself (rather than the oocyte) may still be playing a key role in these better outcomes—though this seems to be of less significance in light of the most recent study by Setti et al, in which SDF had a significant impact on the ICSI cycle outcomes for older women, but no difference on the ICSI cycle outcomes for younger women [ 43 ].…”

“…It is important to remember that most studies of SDF on reproductive outcomes have evaluated neat (unprocessed) sperm samples, not the sperm actually used for insemination or ICSI. Finally, others have suggested that the oocyte itself may have a significant role in compensating for DNA damage and impact outcomes [ 5 , 6 , 19 , 39 , 40 , 41 , 42 , 43 ]. This question has been more fully explored within the last several years, with several contemporary studies evaluating the effect of donor oocytes and maternal age on ICSI cycles performed with high-SDF sperm.…”

“…Finally, in 2022, Hervas et al evaluated over 1900 ICSI cycles utilizing donor oocytes and fresh ejaculated sperm at several fertility centers in Spain [ 42 ]. SDF was measured using a TUNEL assay on a fresh sample produced closest to the day of ICSI (though not on the same sample used for ICSI).…”

“…Cycles were divided into low- (≤15%, n = 1626 cycles) versus high-SDF (>15%, n = 277 cycles) groups. When comparing outcomes per cycle, the authors found no difference in good quality blastocyst rate (24.8% vs. 23.5%, p = 0.4), implantation rate (86.9% vs. 86.6%, p = 0.89), clinical pregnancy rate (50.9% vs. 55.5%, p = 0.17), or live birth rate (36.9% vs. 43.3%, p = 0.29) between the low- and high-SDF groups, respectively [ 42 ]. When calculating the cumulative live birth rate (CLBR) per embryo transfer, per embryos replaced, and per MII oocytes used, there was again no difference between high- vs. low-SDF groups.…”