P-083 The incidence of sperm DNA damage in men with chronic reproductive health issues

Abstract

Abstract Study question What is the incidence of sperm DNA damage in men attending tertiary (urological) healthcare with long histories of infertility? Summary answer The majority of these men (95%), all with normal semen analyses had high levels of sperm DNA damage. What is known already Conventional semen analysis assesses sperm concentration, motility, and morphology but with a high degree of biological variability. Around 25% of men are given a diagnosis of unexplained infertility by normal semen analysis. The World Health Organisation (WHO) stated in 2021 that ‘clinically there is a growing awareness that chromosomal anomalies and gene mutations underlie a diverse spectrum of male infertility,’ so now recommends that sperm DNA is determined as an extended analysis. Sperm DNA damage occurs more often in infertile men and DNA damage is associated with recurrent pregnancy loss and decreased live birth rates following fertility treatment. Study design, size, duration A retrospective study of men attending a tertiary centre with productive failure had been offered a standard semen analysis and sperm DNA fragmentation using SpermComet technology. Participants/materials, setting, methods Results from 148 men tested between April 2017 and September 2021 were recruited from a tertiary urological database in the UK. Alongside a semen analysis, they also had a sperm DNA fragmentation test. Sperm DNA quality for the participants was assessed and reported as average, low and high DNA damage as a percentage compared with clinical thresholds used by Examen from their sperm data bank of 74 fertile sperm donors with recently achieved clinical pregnancies. Main results and the role of chance The average comet score was 37.8% +/-0.5, low comet score was 35.3% +/- 1.5 and high comet score was 20.2% +/-1.2. These values were all significantly outside ( p < 0.001, Mann Whitney test)) fertile parameters. 95% of these men presenting for infertility investigations had a significantly raised DNA damage across their semen sample with low proportions of healthy sperm and high levels of sperm with genomic damage. Limitations, reasons for caution Retrospective design, small sample size, lack of randomisation and low power analysis. Wider implications of the findings Sperm DNA damage was found in most of these men who, over years of investigation hadn't been offered tests other than semen analysis or therapy to improve their sperm quality. Thus, this tool could be a useful adjunct to semen analysis to guide the men to reproductive health. Trial registration number not applicable