Abstract
BackgroundMost studies have mainly focused on the effects of the sperm DNA fragmentation index (DFI) on fertilization, embryonic developmental potential and aneuploidy, pregnancy and abortion rates after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and have remained controversial. However, few studies have reported the effects of sperm DFI on neonatal outcomes, including stillbirths, neonatal deaths, sex, gestational age, prematurity, birthweight, low birth weight (LBW) and birth defects in newborns. Our objective was to evaluate the effects of sperm DFI on the clinical and neonatal outcomes of ICSI cycles.MethodsThis retrospective study analysed a total of 2067 oocyte retrieval, 1139 transfer and 713 delivery cycles from conventional ICSI cycles, including 301, 469, and 214 live-born infants in groups segregated according to sperm DFI as the < 15%, 15–30% and > 30% groups, respectively. The clinical and neonatal outcomes were compared among the three groups.ResultsSperm DFI did not significantly affect the rates of fertilization, clinical pregnancy, miscarriage or ongoing pregnancy. Sperm DFI did not increase the risk of stillbirths or neonatal deaths. The rates of stillbirths and neonatal deaths were not significantly different among the three groups. The sex, gestational age, prematurity, birthweight and LBW of newborns in the three groups were not significantly affected by sperm DFI. Moreover, sperm DFI did not increase the number of birth defects in children.ConclusionsSperm DFI did not affect the clinical or neonatal outcomes of ICSI cycles.
Highlights
Most studies have mainly focused on the effects of the sperm DNA fragmentation index (DFI) on fertilization, embryonic developmental potential and aneuploidy, pregnancy and abortion rates after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and have remained controversial
Female age and male age were significantly different among the three groups, while sperm DFI significantly increased as female age and male age increased (Table 1), which was consistent with the reported literatures [12, 14]
There were no significant differences in birth defects among the three groups (Table 5). This retrospective study showed that sperm DFI did not significantly affect the fertilization, clinical pregnancy, miscarriage, ongoing pregnancy, stillbirths, neonatal deaths, prematurity or low birth weight (LBW) rates, gestational age or birthweight of newborns among the different groups
Summary
Most studies have mainly focused on the effects of the sperm DNA fragmentation index (DFI) on fertilization, embryonic developmental potential and aneuploidy, pregnancy and abortion rates after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and have remained controversial. Zheng et al [5] found that sperm DFI had a negative effect on day 3 embryo quality and the rates of blastocyst formation, implantation and pregnancy in patients undergoing in vitro fertilization (IVF). Sperm DFI was not associated with blastocyst aneuploidy, morphological grading or clinical outcomes after preimplantation genetic screening [9] Another two meta-analyses concluded that sperm DFI did not predict IVF/ICSI outcomes [10, 11]. Antonouli et al [12] reported that sperm DFI did not significantly affect embryonic development or pregnancy rate in ICSI patients with donated oocytes. From the literatures published above, the effect of sperm DFI on embryonic development, implantation and pregnancy remained controversial after IVF/ICSI
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