Sperm chromatin structure assay parameters are not related to fertilization rates, embryo quality, and pregnancy rates in in vitro fertilization and intracytoplasmic sperm injection, but might be related to spontaneous abortion rates
Received 30 January 2007; received in revised form 8 June 2007; accepted 11 June 2007. published online 27 September 2007.
Objective
To investigate the relationship between sperm chromatin structure assay (SCSA) parameters, DNA fragmentation index (DFI) and high DNA stainability (HDS), and outcomes of IVF and intracytoplasmic sperm injection (ICSI).
Design
Retrospective review and prospective study.
Setting
Academic human reproduction laboratory.
Patient(s)
Two hundred twenty-three couples undergoing conventional IVF (n = 137) and ICSI (n = 86).
Intervention(s)
Testing with SCSA on a semen aliquot taken from ejaculate used for assisted reproductive technology (ART).
Main Outcome Measure(s)
Conventional semen parameters, DFI, HDS, outcomes of IVF and ICSI.
Result(s)
There were no significant differences in IVF and ICSI fertilization rate, good embryo rate, and pregnancy rate (PR) between high, moderate, and low DFI or HDS groups. Men with HDS >15% had significantly higher IVF abortion rates. There was a statistically insignificant trend toward an increased abortion rate in the high DFI (>27%) group. The DFI correlated negatively with sperm motility, and HDS correlated negatively with sperm morphology and concentration.
Conclusion(s)
Neither DFI nor HDS scores can provide independent information about embryo quality, fertilization, and PRs for infertility patients undergoing ART. Sperm DNA fragmentation probably affects sperm motility. The relationship between HDS and IVF abortion rates provides preliminary evidence that ICSI may be indicated for men with HDS >15%. The potential adverse effect of sperm DNA damage on the quality of postimplantation embryo and spontaneous abortion should be a concern.
aDepartment of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
bMackay Medicine, Nursing and Management College, Taipei, Taiwan
cDepartment of Medical Research, Mackay Memorial Hospital, Tamshui, Taipei County, Taiwan
dDepartment of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
Reprint requests: Robert Kuo-Kuang Lee, M.D., Department of Obstetrics and Gynecology, Mackay Memorial Hospital, 92 Chung-Shan North Road, Section 2, Taipei 104, Taiwan (FAX: 886-2-25433642).
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