Sperm chromatin structure correlates with spontaneous abortion and multiple pregnancy rates in assisted reproduction

Abstract

The objective of this study was to determine if a relationship exists between sperm parameters, measured by sperm chromatin structure assay (SCSA), and spontaneous abortion and multiple births in couples undergoing assisted reproduction treatment. Retrospective analysis of infertility treatment outcomes and occurrence of spontaneous abortion and multiple births was conducted in 233 couples who underwent treatment by intracytoplasmic sperm injection or intrauterine insemination at the Sher Institute for Reproductive Medicine, between 2001 and 2004. Sperm samples used for treatments were analysed for sperm concentration, sperm motility and two different parameters of SCSA (DNA fragmentation index, DFI, and high DNA stainability, HDS). Pregnancy, spontaneous abortion and multiple birth rates were recorded for all couples. A statistically significant relationship ( P < 0.001) was observed between DFI and spontaneous abortion. However, the correlation between HDS and spontaneous abortion was not statistically significant. Significantly lower levels of DFI were observed in men from couples having triplet pregnancies compared with those in the spontaneous abortion group ( P ⩽ 0.05). It is concluded that the parameters of SCSA correlate significantly with spontaneous abortion and multiple birth and may provide guidance for clinical decision making (number of embryos per transfer) and management of spontaneous abortion-prone cases. The goal of this study was to determine if a relationship exists between the sperm chromatin structure assay (SCSA) and spontaneous abortion and multiple births in couples treated via assisted reproductive technologies such as intra-cytoplasmic sperm injection or intrauterine insemination. SCSA is a test used by fertility clinics to determine if the sperm chromosomes or DNA are properly packaged in the sperm head and are therefore protected from damage that could occur during travel in the female reproductive system. A retrospective analysis of the results of SCSA, infertility treatment outcomes and the occurrence of spontaneous abortions and multiple births was conducted for 233 couples attending an infertility clinic. A statistically significant correlation was found between one of the SCSA parameters and spontaneous abortion. In addition, lower levels of this SCSA parameter were observed in men from couples having triplet pregnancies. We conclude that the parameters of SCSA correlate significantly with spontaneous abortions and multiple births and may provide guidance for clinical decision making, such as number of embryos per transfer or intensive management of spontaneous abortion-prone cases.