Abstract
Our study objective was to assess the effect of various sperm DNA fragmentation levels on clinical intracytoplasmic sperm injection outcome. This retrospective study included 392 patients who underwent ICSI and performed sperm DNA fragmentation testing before the procedure. Based on sperm DNA fragmentation cut-off values, the patients were differentiated into 3 groups as <20%, 20%-30% and >30%. According to the female status, patients were differentiated into favourable group (n=259) with female age <35years and anti-Mullerian hormone level ≥7.1pmol/L; and unfavourable group (n=133) with female age ≥35years and anti-Mullerian hormone level ≤7.1pmol/L. The patient's medical records were reviewed, and patient's demographic, laboratory data including semen analysis, sperm DNA fragmentation determined by means of sperm chromatin dispersion, hormonal profile and data regarding intracytoplasmic sperm injection cycle were collected. This cohort reported that the clinical reproductive outcomes of intracytoplasmic sperm injection showed no statistical significance with increase sperm DNA fragmentation levels. In sperm DNA fragmentation above 30%, favourable females had significantly higher clinical pregnancy rate and live birth rate than unfavourable females, while fertilisation rate and miscarriage rate showed no significance between the subgroups. High sperm DNA fragmentation is linked to poor semen parameters.
Highlights
Infertility is one of the predominant problems affecting around 15% of couples of reproductive ages worldwide with about 50% of causative factors from the male side (Irvine, 1998; Lotti and Maggi, 2018)
sperm DNA fragmentation (SDF) occurs during late spermatogenesis due to defects in the repair system of DNA (Bui et al, 2018) which can be caused by different pathological mechanisms including apoptosis, elevated oxidative stress due to an increase in reactive oxygen species (ROS), and dysregulation of the chromatin protamine and histone components
The current study examined the impact of SDF, measured with the Sperm Chromatin Dispersion (SCD) test, on the reproductive outcomes with ICSI; namely, clinical pregnancy, live birth, fertilisation, and miscarriage rates
Summary
Infertility is one of the predominant problems affecting around 15% of couples of reproductive ages worldwide with about 50% of causative factors from the male side (Irvine, 1998; Lotti and Maggi, 2018). SDF occurs during late spermatogenesis due to defects in the repair system of DNA (Bui et al, 2018) which can be caused by different pathological mechanisms including apoptosis, elevated oxidative stress due to an increase in reactive oxygen species (ROS), and dysregulation of the chromatin protamine and histone components. These changes may occur as a result of various factors like drug use, tobacco smoking, environmental pollution, high testicular temperature, and advanced age (Sergerie et al, 2005). The exact mechanism by which the oocyte can repair the SDF remains unknown human oocytes occupy DNA repair genes and can be linked to maternal mRNA repair (Osman et al, 2015)
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