Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome |
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| Authors: | Bungum M Humaidan P Axmon A Spano M Bungum L Erenpreiss J Giwercman A |
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| Affiliation: | 1 Fertility Clinic, Viborg Hospital (Skive), Skive, Denmark 2 Fertility Centre, Scanian Andrology Centre, Malmö University Hospital, Malmö 3 Division of Occupational and Environmental Medicine and Psychiatric Epidemiology, Lund University, Lund, Sweden and 4 Section of Toxicology and Biomedical Sciences, BIOTEC-MED, ENEA Casaccia Research Center, Rome, Italy |
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| Abstract: | BACKGROUND: The sperm chromatin structure assay (SCSA) has beensuggested as a predictor of fertility in vivo as well as invitro. The available data however, have been based on limitednumbers of treatments. We aimed to define the clinical roleof SCSA in assisted reproduction. METHODS: A total of 998 cycles[387 intrauterine insemination (IUI), 388 IVF and 223 ICSI]from 637 couples were included. SCSA results were expressedas DNA fragmentation index (DFI) and high DNA stainable (HDS)cell fractions. Outcome parameters were biochemical pregnancy(BP), clinical pregnancy (CP) and delivery (D). RESULTS: ForIUI, the odds ratios (ORs) for BP, CP and D were significantlylower for couples with DFI >30% as compared with those withDFI  30%. No statistical difference between the outcomes of ICSIversus IVF in the group with DFI 30% was seen. In the DFI >30%group, the results of ICSI were significantly better than thoseof IVF. CONCLUSIONS: DFI can be used as an independent predictorof fertility in couples undergoing IUI. As a result, we proposethat all infertile men should be tested with SCSA as a supplementto the standard semen analysis. When DFI exceeds 30%, ICSI shouldbe the method of choice. |
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| Keywords: | ICSI/IUI/IVF/SCSA/sperm DNA |
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