Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome

Purpose Standard semen parameters are poor predictors of fertility potential. To date, apart from, paternal karyotyping sperm factors are not evaluated in recurrent pregnancy loss (RPL), only recent studies have emphasized the role of sperm factors in early embryonic development as sperm transcribes genes critical for early embryonic development. Sperm DNA integrity is useful diagnostic and prognostic marker and has clinical implications in idiopathic recurrent pregnancy loss (iRPL) following spontaneous conception. The aim of this study was to assess DNA integrity in cases experiencing iRPL following spontaneous conception. Methods Semen samples from 45 patients and 20 controls were analyzed as per WHO 1999 guidelines and sperm chromatin structure assay (SCSA) was used to measure DNA fragmentation index (DFI). Results By applying receiver operating curve (ROC) analysis, sperm DFI of approximately 26 % was found in male partner of couples experiencing iRPL. Conclusions Our data indicate that sperm from men with a history of iRPL have a higher percentage of DNA damage as compared to control group, and this can explain pregnancy loss in these patients. Men with higher DFI are infertile whereas men with lower DFI (26 %) are able to conceive but experience recurrent pregnancy loss. Thus it is important to evaluate sperm DFI in couples experiencing iRPL to understand exact aetiology of RPL and determine prognosis and management.

Section: Discussionsupporting

confidence: 58%

Predictive value of DNA integrity analysis in idiopathic recurrent pregnancy loss following spontaneous conception

Kumar

Deka

Singh

et al. 2012

“…Several studies have been carried out in order to identify whether DNA damage may be considered a good predictor of ART outcomes and how it may influence pregnancy rates. In one of the largest ever reported studies investigating the predictive value of a DNA fragmentation assay in the determination of intrauterine insemination (IUI), IVF, and ICSI, the DFI was identified as a new determining factor in ART outcome [22].…”

Section: Discussionmentioning

confidence: 99%

The pellet swim-up is the best technique for sperm preparation during in vitro fertilization procedures

Volpes

Sammartano

Rizzari

et al. 2016

Purpose The aim of this study was to investigate the most suitable sperm preparation technique to apply in order to obtain a spermatozoon population with minimal DNA damage during in vitro fertilization procedures. We compared four preparation techniques: direct swim-up (DSU), pellet swimup (PSU), density gradient (DG), and density gradient followed by swim-up (DG-SU), evaluating the effects of each technique on the DNA damage rate, evaluated by DNA fragmentation index of the spermatozoa obtained. Methods In this observational study, 98 semen samples from couples undergoing IVF/ICSI cycles were included. Data were collected between April and November 2014 at the ANDROS Day Surgery Clinic, Palermo, Italy. Result(s) The percentages of DNA fragmentation were 18.30 ± 10.8 in raw samples, 6.6 ± 5.7 after DSU, 4.2 ± 3.8 after PSU, 12.9 ± 9.9 after DG, and 3.7 ± 4.0 after DG-SU respectively. Compared to the raw evaluation, all the preparation techniques significantly decreased the total rate of the DNA fragmentation (DSU Z = −8.60, P < 0.008; PSU Z = −8.54, P < 0.008; DG Z = −6.42, P < 0.008, and DG-SU Z = −8.60, P < 0.008, respectively). Comparing them, spermatozoa with intact DNA after PSU and DG-SU were significantly higher than after DSU (Z = −7.12, P < 0.008; Z = −6.59, P < 0.008, respectively) and after DG (Z = −8.41, P < 0.008; Z = −8.60, P < 0.008, respectively). The difference between PSU and DG-SU was not significant (Z = −2.21, P = 0.03). Conclusion(s) There are, above all, two techniques of sperm preparation which allow for the recovery of spermatozoa with the lowest DNA fragmentation rate. Furthermore, given low costs and reduced time, we believe that PSU is the best option in the treatment of semen samples during IVF/ICSI.

“…Semen analysis provides limited prognostic information on fertility, and recent studies indicated that the integrity of sperm DNA might be a more accurate and precise predictor of fertility [3] an intact DNA is necessary for the correct transmission of genetic materiel to the next generation. High levels of sperm DNA damage have been reported to affect fertility potential, increase the risk of recurrent miscarriages, decrease the chances of a successful implantation, and possibly lead to negative effects on the health of offspring [4,5]. Sperm DNA integrity as assessed by terminal desoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) [6], sperm chromatin structure assay (SCSA) [7,8], and Comet assay [9], were also shown to be compromised with advancing age.…”

Section: Introductionmentioning

confidence: 99%

The effects of male aging on semen quality, sperm DNA fragmentation and chromosomal abnormalities in an infertile population

Brahem

Mehdi

Elghezal

et al. 2011

107

Purpose To investigate the effects of male aging on semen quality, DNA fragmentation and chromosomal abnormalities in the spermatozoa of infertile patients and fertile men. Methods Semen samples of 140 infertile patients (24-76 years) and 50 men with proven fertility (25-65 years) were analyzed according to WHO guidelines. DNA fragmentation was detected by TUNEL assay, while aneuploidy was assessed by FISH. Results In the patient group, semen volume and vitality of spermatozoa decreased significantly with age, while sperm concentration showed a statistically significant increase with age. DNA fragmentation as well as disomy of sex chromosomes and disomy 8 did not show a statistically significant change with age. However, the diploidy rate was significantly increased with patient's age. In the control group, conventional semen parameters as well as DNA fragmentation and chromosomal abnormalities did not show a statistically significant with age. Conclusion Increased age in infertile men is associated with an increase in sperm concentration and diploidy, as well as a decline in semen volume and sperm vitality. However motility, morphology and DNA fragmentation are not affected by male age.