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Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility.

Abstract

OBJECTIVE

To study the implications of sperm DNA fragmentation (SDF) in intracytoplasmic sperm injection cycles for non-male factor infertility.

DESIGN

Prospective cohort study.

SETTING

Private university-affiliated IVF center.

PATIENT(S)

Data from 475 cycles performed from June 2016 to June 2017.

INTERVENTION(S)

Cycles were divided according to SDF rate into two groups: <30% SDF (n = 433) and ≥30% SDF (n = 42). Laboratory and clinical outcomes were compared between groups by generalized linear models adjusted for potential confounders.

MAIN OUTCOME MEASURE(S)

Embryo quality and miscarriage rates.

RESULT(S)

Fertilization rate was similar between groups (≥30% SDF, 85.28% ± 1.06% vs. <30% SDF, 90.68% ± 3.61%). Significantly lower rates of normal cleavage speed (≥30% SDF, 61.12% ± 4.21% vs. <30% SDF, 72.53% ± 1.24%), high-quality embryos at day 3 (≥30% SDF, 23.07% ± 5.56% vs. <30% SDF, 36.41% ± 1.53%), blastocyst formation (≥30% SDF, 39.09% ± 2.73% vs. <30% SDF, 58.83% ± 7.59%), blastocyst quality (≥30% SDF, 11.97% ± 1.22% vs. <30% SDF, 30.09% ± 2.39%), and implantation (33.24% ± 1.66% vs. <30% SDF, 46.40% ± 4.61%) were observed in cycles with higher SDF, despite similar pregnancy rates (≥30% SDF, 30.40% vs. <30% SDF, 32.40%). A 2.5-fold miscarriage rate was observed in cycles with an SDF above the established cutoff (≥30% SDF, 42.8% vs. <30% SDF, 16.8%).

CONCLUSION(S)

Higher SDF is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in non-male factor infertility intracytoplasmic sperm injection cycles. Since defects in sperm may be hidden, the SDF test can bring additional information to the sperm quality evaluation of men with unknown infertility history.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil. Electronic address: edson@fertility.com.br.

    ,

    Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.

    ,

    Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.

    ,

    Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.

    ,

    Fertility Medical Group, São Paulo, Brazil.

    Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.

    Source

    Fertility and sterility : 2019 Jun 11 pg

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31200969

    Citation

    Borges, Edson, et al. "Sperm DNA Fragmentation Is Correlated With Poor Embryo Development, Lower Implantation Rate, and Higher Miscarriage Rate in Reproductive Cycles of Non-male Factor Infertility." Fertility and Sterility, 2019.
    Borges E, Zanetti BF, Setti AS, et al. Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertil Steril. 2019.
    Borges, E., Zanetti, B. F., Setti, A. S., Braga, D. P. A. F., Provenza, R. R., & Iaconelli, A. (2019). Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertility and Sterility, doi:10.1016/j.fertnstert.2019.04.029.
    Borges E, et al. Sperm DNA Fragmentation Is Correlated With Poor Embryo Development, Lower Implantation Rate, and Higher Miscarriage Rate in Reproductive Cycles of Non-male Factor Infertility. Fertil Steril. 2019 Jun 11; PubMed PMID: 31200969.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. AU - Borges,Edson,Jr AU - Zanetti,Bianca Ferrarini, AU - Setti,Amanda Souza, AU - Braga,Daniela Paes de Almeida Ferreira, AU - Provenza,Rodrigo Rosa, AU - Iaconelli,Assumpto,Jr Y1 - 2019/06/11/ PY - 2018/11/01/received PY - 2019/04/22/revised PY - 2019/04/22/accepted PY - 2019/6/16/entrez KW - ICSI KW - Sperm chromatin dispersion KW - non–male factor infertility KW - semen analysis KW - sperm DNA fragmentation JF - Fertility and sterility JO - Fertil. Steril. N2 - OBJECTIVE: To study the implications of sperm DNA fragmentation (SDF) in intracytoplasmic sperm injection cycles for non-male factor infertility. DESIGN: Prospective cohort study. SETTING: Private university-affiliated IVF center. PATIENT(S): Data from 475 cycles performed from June 2016 to June 2017. INTERVENTION(S): Cycles were divided according to SDF rate into two groups: <30% SDF (n = 433) and ≥30% SDF (n = 42). Laboratory and clinical outcomes were compared between groups by generalized linear models adjusted for potential confounders. MAIN OUTCOME MEASURE(S): Embryo quality and miscarriage rates. RESULT(S): Fertilization rate was similar between groups (≥30% SDF, 85.28% ± 1.06% vs. <30% SDF, 90.68% ± 3.61%). Significantly lower rates of normal cleavage speed (≥30% SDF, 61.12% ± 4.21% vs. <30% SDF, 72.53% ± 1.24%), high-quality embryos at day 3 (≥30% SDF, 23.07% ± 5.56% vs. <30% SDF, 36.41% ± 1.53%), blastocyst formation (≥30% SDF, 39.09% ± 2.73% vs. <30% SDF, 58.83% ± 7.59%), blastocyst quality (≥30% SDF, 11.97% ± 1.22% vs. <30% SDF, 30.09% ± 2.39%), and implantation (33.24% ± 1.66% vs. <30% SDF, 46.40% ± 4.61%) were observed in cycles with higher SDF, despite similar pregnancy rates (≥30% SDF, 30.40% vs. <30% SDF, 32.40%). A 2.5-fold miscarriage rate was observed in cycles with an SDF above the established cutoff (≥30% SDF, 42.8% vs. <30% SDF, 16.8%). CONCLUSION(S): Higher SDF is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in non-male factor infertility intracytoplasmic sperm injection cycles. Since defects in sperm may be hidden, the SDF test can bring additional information to the sperm quality evaluation of men with unknown infertility history. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/31200969/Sperm_DNA_fragmentation_is_correlated_with_poor_embryo_development,_lower_implantation_rate,_and_higher_miscarriage_rate_in_reproductive_cycles_of_non-male_factor_infertility L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(19)30408-X DB - PRIME DP - Unbound Medicine ER -