Sperm DNA fragmentation index and high DNA stainability do not influence pregnancy success after intracytoplasmic sperm injection

Abstract

Objective: To evaluate the ability of sperm DNA fragmentation index (DFI) and high DNA stainability (HDS) to influence the chance of achieving pregnancy in couples undergoing intracytoplasmic sperm injection (ICSI) cycles. Design: A retrospective study evaluating couples who underwent an ICSI cycle between 2009 and 2018. Setting: Reproductive center. Patient(s): Consecutive couples who underwent an ICSI cycle and had a semen analysis with subsequent DFI and HDS testing, evaluated using Sperm Chromatin Structure Assay. Intervention(s): Measurement of DFI and HDS prior to ICSI cycle. Main Outcome Measure(s): To determine whether DFI or HDS of sperm was predictive of the number of ICSI cycles until the first clinical intrauterine pregnancy. Result(s): A total of 550 couples who underwent 1,050 ICSI cycles were analyzed. Of those, a total of 330 couples achieved pregnancy.As expected, in couples who achieved pregnancy, females were younger and underwent fewer cycles. Importantly, the DFI and HDS were similar between couples who achieved pregnancy (DFI% 12.9; HDS% 9.3) and couples who did not (DFI% 12.2; HDS% 9.1). A multivariable-adjusted analysis evaluating female age at the first cycle was associated negatively with pregnancy. Conclusion(s):Neither DFI nor HDS at baseline influenced the chances of a couple to achieve pregnancy after ICSI. Increased female age and couples who underwent more ICSI cycles were associated with lower chances of achieving pregnancy. (Fertil Steril Rep Ò 2020;1: 233-8. Ó2020 by American Society for Reproductive Medicine.

Advanced Paternal Age and Sperm DNA Fragmentation: A Systematic Review

“…Three of the four studies showed a significant difference (p<0.01) in favor of APA increasing DNA fragmentation, even among normozoospermic males [ 21 22 24 ]. All six studies examining DNA fragmentation between fertile and infertile males with proven primary or secondary infertility, which reported a significant difference in favor of increasing DNA fragmentation with APA [ 25 26 27 28 29 30 ]. Four studies examined males with proven primary or secondary infertility [ 31 32 33 34 ].…”

“…Studies were at high risk of applicability concerns in domain “reference standard” when the patient's age category threshold is not comparable to the thresholds of other studies. Overall, the domain “index test” was considered to be at “low risk” because there were 10 studies that utilized TUNEL assay [ 21 23 25 26 27 31 32 33 38 39 ], 6 studies utilizing SCSA [ 22 28 30 34 35 37 ], 1 study using Comet assay [ 36 ], and 2 studies that utilized the SCD to quantify DNA fragmentation [ 24 29 ].…”