Does Sperm DNA Fragmentation test in Cases of Male Factor Infertility Improve ICSI outcome?

Abstract

Background: Sperm DNA fragmentation is an uprising factor af- fecting male fertility and some previous results have shown signifi- cant effect of SDF on ART techniques outcomes. Objective: To study effect of DNA fragmentation testing and treat- ment on ICSI outcome among infertile couples with male factor in- fertility. Patients and Method: After approval of ethics committee,prospec- tive control randomized study was conducted among a total of 106 infertile couples arranged for intracytoplasmic sperm injection (ICSI) due to male factor. Males were divided by simple random allocation into 2 groups. Group I included 53 males that were tested for DNA fragmentation test (Halo test). Group II included 53 males that were directly offered ICSI cycle.Infertile couples were evaluated as regard to fertilization rate, day 5 embryo transfer, positive pregnancy test, clinical pregnancy evaluated by visible sac with viable fetus on ultra- sonographic assessment and delivery of normal viable baby. Results: Men with initially negative DNA fragmentation test and those with positive DNA fragmentation test who responded well to treatment were found to have higher fertilization ratio of M2 ova, day 3 grade I embryo, blastocyte, positive pregnancy test and positive clin- ical pregnancy compared to non responders to treatment. There was no statistically significant difference between testicular and ejaculated sperm ICSI outcome among males with persistent sperm DNA frag- mentation test. Conclusion: Sperm DNA fragmentation is an important factor that significantly affects ICSI outcome. None of testicular or ejaculated sperm is superior regarding ICSI outcome among males with DNA fragmentation.