Abstract

During the last decades, many studies have shown the possible influence of sperm DNA fragmentation on assisted reproductive technique outcomes. However, little is known about the impact of sperm DNA fragmentation on the clinical outcome of frozen-thawed embryo transfer (FET) from cycles of conventional in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI). In the present study, the relationship between sperm DNA fragmentation (SDF) and FET clinical outcomes in IVF and ICSI cycles was analyzed. A total of 1082 FET cycles with cleavage stage embryos (C-FET) (855 from IVF and 227 from ICSI) and 653 frozen-thawed blastocyst transfer cycles (B-FET) (525 from IVF and 128 from ICSI) were included. There was no significant change in clinical pregnancy, biochemical pregnancy and miscarriage rates in the group with a SDF >30% compared with the group with a SDF ≤30% in IVF and ICSI cycles with C-FET or B-FET. Also, there was no significant impact on the FET clinic outcome in IVF and ICSI when different values of SDF (such as 10%, 20%, 25%, 35%, and 40%) were taken as proposed threshold levels. However, the blastulation rates were significantly higher in the SDF ≤30% group in ICSI cycle. Taken together, our data show that sperm DNA fragmentation measured by Sperm Chromatin Dispersion (SCD) test is not associated with clinical outcome of FET in IVF and ICSI. Nonetheless, SDF is related to the blastocyst formation in ICSI cycles.

Highlights

  • Sperm DNA damage is increasingly being recognized as an important cause of infertility and has better diagnostic and prognostic capabilities than routine semen parameters [1]

  • Sperm DNA damage has been shown to adversely affect reproductive outcomes [15], the true clinical significance of sperm DNA damage assays remains to be established since the available studies are few and heterogeneous [16]

  • Little is known about the impact of sperm DNA fragmentation on clinical outcome of frozen-thawed embryo transfer (FET) following conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI)

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Summary

Introduction

Sperm DNA damage is increasingly being recognized as an important cause of infertility and has better diagnostic and prognostic capabilities than routine semen parameters [1]. Routine semen parameters may not reveal sperm defects affecting the integrity of the male genome. One of the main cause of male infertility with normal spermiogram may be related abnormalities in the male genome characterized by damaged DNA, which is highly indicative of male subfertility regardless of routine semen parameters [2,3,4]. Assisted reproductive technique (ART) has revolutionized the management of severe male infertility and increased the chance of sperm with abnormal genome to fertilize the oocyte [1]. Sperm DNA damage has been shown to adversely affect reproductive outcomes [15], the true clinical significance of sperm DNA damage assays remains to be established since the available studies are few and heterogeneous [16].

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