Clin Exp Reprod Med.  2017 Dec;44(4):224-231. 10.5653/cerm.2017.44.4.224.

Impact of sperm DNA fragmentation on clinical in vitro fertilization outcomes

• Choi HY
• Kim SK
• Kim SH
• Choi YM
• Jee BC

• KMID: 2401625
• DOI: http://doi.org/10.5653/cerm.2017.44.4.224

Abstract

OBJECTIVE
We studied the association between sperm DNA fragmentation (SDF) and several clinical in vitro fertilization outcomes.
METHODS
We retrospectively analyzed 169 consecutive fresh IVF cycles. Semen was collected on the day of oocyte retrieval, and we assessed standard semen parameters and the SDF level (by terminal deoxynucleotidyl transferase dUTP nick-end labeling). Poor ovarian response (POR) was defined as the collection of three or fewer mature oocytes. Oocytes were inseminated by the conventional method or intracytoplasmic sperm injection.
RESULTS
SDF did not affect the fertilization or pregnancy rate, but did have a significant effect on the miscarriage rate. In the miscarriage group (n=10), the SDF level was significantly higher (23.9% vs. 14.1%) and number of mature oocytes was significantly lower (4.3 vs. 7.6) than in the live birth group (n=45). Multiple regression analysis showed that SDF was an independent predictor of miscarriage (odds ratio, 1.051; 95% confidence interval, 1.001-1.104). The cutoffs for the SDF level and number of mature oocytes that could predict miscarriage were >13% and ≤3, respectively. In the low-SDF group (≤13%), the miscarriage rate was similar in POR patients and those with a normal ovarian response (NOR; 14.2% vs. 4.3%). In the high-SDF group (>13%), the miscarriage rate was significantly higher in the POR group than in the NOR group (60.0% vs. 13.3%, p=0.045).
CONCLUSION
Our study demonstrated that a high SDF level (>13%) was associated with a high miscarriage rate, and that it mainly contributed to miscarriage in the POR group. The results suggest that SDF measurements should be considered in couples with POR in order to predict the prognosis of the pregnancy.

Keyword

Abortion; DNA fragmentation; Fertilization in vitro; Pregnancy; Spermatozoa

MeSH Terms

Abortion, Spontaneous
DNA Fragmentation*
DNA Nucleotidylexotransferase
DNA*
Family Characteristics
Female
Fertilization
Fertilization in Vitro*
Humans
In Vitro Techniques*
Live Birth
Methods
Oocyte Retrieval
Oocytes
Pregnancy
Pregnancy Rate
Prognosis
Retrospective Studies
Semen
Sperm Injections, Intracytoplasmic
Spermatozoa*
DNA
DNA Nucleotidylexotransferase