Abstract

Abstract Study question Whether the percentage of different sperm chromatin dispersion type are associated with the IVF/ICSI outcome and offspring profile? Summary answer Percentage of different sperm chromatin dispersion type are significantly associated with the embryo cleavage rate, embryo quality, live birth rate and offspring gender. What is known already The sperm DNA fragmentation index (DFI) is increasingly recognized as a key sperm functional parameter for assessing male fertility. Sperm chromatin dispersion (SCD) test is widely used in clinical andrology lab to measure DFI, and according to the size of sperm halo it divides sperm into three categories: big halo sperm, middle halo sperm, small or no halo sperm. Previous study reported that big halo sperm are significantly associated with embryo quality and pregnancy rate. The average halo size of Y-chromosome bearing sperm are significantly smaller than X - chromosome bearing sperm. Study design, size, duration This is a multi-center retrospective study recruited 200 couples underwent IVF/ICSI treatment in Nanfang Hospital and Guangdong Women's and Children's Hospital from May 2018 to May 2019. Participants/materials, setting, methods Patients meet the followed inclusion criteria were recruited: (1) The male partners received sperm chromatin dispersion test; (2) The female partners have normal ovarian reserve (female age < 35 years old, FSH ≤10 IU/L and AFC ≥ 5); (3) Couples received fresh single embryo transfer. The association between sperm chromatin dispersion type and IVF/ICSI outcome and the offspring profile were retrospectively analyzed. Main results and the role of chance Regression analysis showed that the embryo cleavage rate is positively associated with the percentage of sperm with big halo (Adjusted ?????(95% CI) 0.09 (0.01, 0.17), P<0.05), but negatively associated with the percentage of sperm with middle halo (Adjusted ????? (95% CI)- 0.22 (-0.35, -0.09), P<0.001). The good embryo rate is negatively associated with the percentage of sperm with middle halo (Adjusted ????? (95% CI) -0.60 (-1.04, -0.16), P<0.05). Live birth is significantly associated with the percentage of sperm with small halo (Adjusted OR (95% CI) 0.89 (0.80, 1.00), P<0.05). Offspring gender is significantly associated with the percentage of sperm with big halo (Adjusted OR (95% CI) 0.95 (0.91, 0.99), P<0.05) and the percentage of sperm with middle halo (Adjusted OR (95% CI) 1.09 (1.02, 1.17), P<0.05). The area under the receiver operator characteristic (ROC) curve (AUC) of the big halo sperm percentage to predict male offspring is 0.68 (95%CI (0.54, 0.81), P < 0.05). The AUC of middle halo sperm percentage to predict female offspring is 0.66 (95%CI (0.52, 0.80), P < 0.05). Limitations, reasons for caution This is a retrospective study which may have the bias caused by the nature of this type of study. The sample size is relatively small. Wider implications of the findings The percentage of big halo sperm are significantly associated with embryo cleavage rate and male offspring. The percentage of middle halo sperm are significantly associated with embryo cleavage rate, lower good embryo rate and female offspring. The percentage of small halo sperm is significantly associated with live birth. Trial registration number 82101683

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