Sperm DNA fragmentation index and cumulative live birth rate in a cohort of 2,713 couples undergoing assisted reproduction treatment

Abstract

Objective: To study how the choice of the first assisted reproductive technology treatment type affects the cumulative live birth rate (CLBR) in couples with high sperm DNA fragmentation index (DFI). Design: Longitudinal cohort study. Setting: University-affiliated fertility clinic. Patient(s): A total of 2,713 infertile couples who underwent assisted reproductive technology treatment between 2007 and 2017 were included in the study. All in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments (up to three fresh treatments and all associated frozen-thawed embryo transfers) offered to the couples by the public health care system were included, in total 5,422 cycles. Intervention(s): None. Main Outcome Measure(s): The primary outcome was the CLBR. The secondary outcomes were the fertilization rate and the miscarriage rate. The IVF and ICSI groups were defined according to the method applied in the first treatment cycle. Result(s): In the IVF group, the CLBR values were higher for couples with normal DFI compared with those for couples with high DFI (R20%) (48.1% vs. 41.6% for conservative CLBR estimate and 55.6% vs. 51.4% for optimal CLBR estimate after adjustment for female age, respectively). No DFI-dependent difference was seen in the ICSI group. Conclusion(s):Our results demonstrated that a high DFI predicts a statistically significantly lower CLBR if IVF and not ICSI is applied in the first cycle of assisted reproduction.

Investigation of the mechanisms leading to human sperm DNA damage based on transcriptome analysis by RNA-seq techniques

“…Sperm DNA integrity is crucial for fertilization and the development of healthy offspring, and more and more studies have confirmed that sperm DNA damage is related to male infertility (Agarwal et al, 2020). Sperm DNA fragmentation index (DFI) can reflect the integrity of sperm DNA, and is used as an important indicator to evaluate semen quality (Malic Voncina et al, 2021;Yan et al, 2022). This study performed the bioinformatics analysis on the transcriptome data of human sperm with high DNA fragmentation and normal DNA fragmentation, and screened out differentially expressed RNAs.…”

Sperm DNA fragmentation: What have we learned so far?

“…The current study by Voncina et al (2) attempts to identify, in a patient population routinely screened for DNA fragmentation index (DFI), the impact of a compromised sperm genome on IVF and ICSI outcomes. Although it is well designed and includes a well-proven test, the study is limited by being a cohort study and lacks randomization.…”

Correlations between elevated basal sperm DNA fragmentation and the clinical outcomes in women undergoing IUI

“…Sperm DNA as a carrier of paternal genetic information, plays an important role in fertilization and embryonic development (48). Sperm DFI can reflect the integrity of sperm DNA and is an important indicator to assist in the evaluation of semen quality after the traditional semen analysis (3,4). Oguz et al compared the effects of two commonly used sperm preparation methods (swim-up and gradient technique) on sperm DFI through SCD method, and the result showed that gradient method has no statistically significant reduction in the DNA fragmented sperm rate after preparation as compared to basal rates (49).…”

“…Sperm DNA integrity is crucial for fertilization and the development of healthy offspring, and more and more reports emphasize the direct relationship between sperm DNA damage and male infertility (2). Sperm DFI can reflect the integrity of sperm DNA, and is an important indicator to assist in the evaluation of semen quality after the traditional semen analysis (3,4). With the continuous development of science and technology, many new technologies have been applied to the examination of sperm DFI in clinical practice, including the TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay, Comet assay, SCSA (sperm chromatin structure assay), SCD (sperm chromatin dispersion) test, etc.…”