Sperm DNA fragmentation in couples with unexplained recurrent spontaneous abortions

Khadem, N; Poorhoseyni, A.; Jalali, Mehdi; Akbary, Ali; Heydari, Seyed Taghi

doi:10.1111/and.12056

Cited by 69 publications

(57 citation statements)

References 23 publications

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“…Using SCD, Khadem et al compared 30 couples with RSA to another 30 control couples (72). The SDF was higher in the RSA group than in the control group (43.3% vs. 16.7%, P=0.024) (72).…”

Section: Indications For Sdf Testingmentioning

confidence: 99%

“…Using SCD, Khadem et al compared 30 couples with RSA to another 30 control couples (72). The SDF was higher in the RSA group than in the control group (43.3% vs. 16.7%, P=0.024) (72). Another study using the SCD test similarly demonstrated a significantly higher SDF in the RSA group compared to the control group (P≤0.05) (73).…”

Section: Indications For Sdf Testingmentioning

confidence: 99%

See 1 more Smart Citation

Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios

Agarwal¹,

Majzoub²,

Esteves³

et al. 2016

Transl. Androl. Urol.

327

415

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Sperm DNA fragmentation (SDF) has been generally acknowledged as a valuable tool for male fertility evaluation. While its detrimental implications on sperm function were extensively investigated, little is known about the actual indications for performing SDF analysis. This review delivers practice based recommendations on commonly encountered scenarios in the clinic. An illustrative description of the different SDF measurement techniques is presented. SDF testing is recommended in patients with clinical varicocele and borderline to normal semen parameters as it can better select varicocelectomy candidates. High SDF is also linked with recurrent spontaneous abortion (RSA) and can influence outcomes of different assisted reproductive techniques. Several studies have shown some benefit in using testicular sperm rather than ejaculated sperm in men with high SDF, oligozoospermia or recurrent in vitro fertilization (IVF) failure. Infertile men with evidence of exposure to pollutants can benefit from sperm DNA testing as it can help reinforce the importance of lifestyle modification (e.g., cessation of cigarette smoking, antioxidant therapy), predict fertility and monitor the patient’s response to intervention.

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“…Using SCD, Khadem et al compared 30 couples with RSA to another 30 control couples (72). The SDF was higher in the RSA group than in the control group (43.3% vs. 16.7%, P=0.024) (72).…”

Section: Indications For Sdf Testingmentioning

confidence: 99%

Section: Indications For Sdf Testingmentioning

confidence: 99%

Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios

Agarwal¹,

Majzoub²,

Esteves³

et al. 2016

Transl. Androl. Urol.

327

415

View full text Add to dashboard Cite

show abstract

“…A meta-analysis of 16 cohort studies involving 2,969 couples found a significant increase in miscarriage in patients with high SDF 146. Two recent cohort studies found SDF, measured with sperm chromatin dispersion test, to be significantly higher in couples in the URPL group compared to a control group of fertile men 147,148. Therefore, it seems reasonable to offer SDF testing to couples with otherwise URPL.…”

Section: Unexplained Rpl (Urpl)mentioning

confidence: 99%

Recurrent pregnancy loss: current perspectives

Hachem

Crepaux

May‐Panloup

et al. 2017

IJWH

338

209

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Recurrent pregnancy loss is an important reproductive health issue, affecting 2%–5% of couples. Common established causes include uterine anomalies, antiphospholipid syndrome, hormonal and metabolic disorders, and cytogenetic abnormalities. Other etiologies have been proposed but are still considered controversial, such as chronic endometritis, inherited thrombophilias, luteal phase deficiency, and high sperm DNA fragmentation levels. Over the years, evidence-based treatments such as surgical correction of uterine anomalies or aspirin and heparin for antiphospholipid syndrome have improved the outcomes for couples with recurrent pregnancy loss. However, almost half of the cases remain unexplained and are empirically treated using progesterone supplementation, anticoagulation, and/or immunomodulatory treatments. Regardless of the cause, the long-term prognosis of couples with recurrent pregnancy loss is good, and most eventually achieve a healthy live birth. However, multiple pregnancy losses can have a significant psychological toll on affected couples, and many efforts are being made to improve treatments and decrease the time needed to achieve a successful pregnancy. This article reviews the established and controversial etiologies, and the recommended therapeutic strategies, with a special focus on unexplained recurrent pregnancy losses and the empiric treatments used nowadays. It also discusses the current role of preimplantation genetic testing in the management of recurrent pregnancy loss.

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“…In a study researching 106 men in couples struggling with fertility issues who had miscarriages in the past, Check et al [55] found that a DFI of 30% or higher was related to high miscarriage rates and low ongoing pregnancy rates. Khadem et al [56] also reported that recurrent miscarriages and high levels of sperm DNA damage had a positive correlation. In conclusion, SDF measurements can be seen as a useful tool in predicting miscarriages related to paternal factors.…”

Section: Clinical Significance Of Sperm Dna Damage For Pregnancymentioning

confidence: 99%

What should be done for men with sperm DNA fragmentation?

Kim

2018

Clin Exp Reprod Med

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In an age when a small quantity of sperm can lead to pregnancy through in vitro fertilization or intracytoplasmic sperm injection, selecting healthy sperm is important. Sperm DNA fragmentation (SDF) is known to be higher in infertile men. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) and the alkaline comet test are SDF tests that directly measure DNA damage and have shown closer correlations with assisted reproduction results than indirect tools such as the sperm chromatin structure assay or the sperm chromatic dispersion test. It is difficult; however, to endorse a single test as the best test overall; instead, it is best to select a testing method based on each patient's clinical condition and goals. In a couple struggling with infertility, if the male partner has a high level of SDF, he should aim to decrease SDF through lifestyle modifications, antioxidant treatment, and ensuring an appropriate duration of abstinence, and physicians need to treat the underlying diseases of such patients. If sperm DNA damage continues despite the patient's and physician's efforts, other methods, such as micromanipulation-based sperm selection or testicular sperm extraction, should be used to select healthy sperm with nuclear DNA integrity.

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Sperm DNA fragmentation in couples with unexplained recurrent spontaneous abortions

Cited by 69 publications

References 23 publications

Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios

Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios

Recurrent pregnancy loss: current perspectives

What should be done for men with sperm DNA fragmentation?

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