Clinical and Experimental Reproductive Medicine

  • 제44권4호
  • /
  • Pages.224-231
  • /
  • 2017
  • /
  • 2233-8233(pISSN)
  • /
  • 2233-8241(eISSN)
대한생식의학회 (The Korean Society for Reproductive Medicine)
권호 표지
DOI QR코드

DOI QR Code

Impact of sperm DNA fragmentation on clinical in vitro fertilization outcomes

  • Choi, Hwa Young (Department of Obstetrics and Gynecology, Maria Fertility Hospital) ;
  • Kim, Seul Ki (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Kim, Seok Hyun (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Choi, Young Min (Department of Obstetrics and Gynecology, Seoul National University College of Medicine) ;
  • Jee, Byung Chul (Department of Obstetrics and Gynecology, Seoul National University College of Medicine)
  • 투고 : 2017.10.04
  • 심사 : 2017.10.26
  • 발행 : 2017.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

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 ${\leq}3$, respectively. In the low-SDF group (${\leq}13%$), 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.

키워드

참고문헌

  1. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. Geneva: World Health Organization; 2010.
  2. Practice Committee of the American Society for Reproductive Medicine. The clinical utility of sperm DNA integrity testing: a guideline. Fertil Steril 2013;99:673-7. https://doi.org/10.1016/j.fertnstert.2012.12.049
  3. Li Z, Wang L, Cai J, Huang H. Correlation of sperm DNA damage with IVF and ICSI outcomes: a systematic review and meta-analysis. J Assist Reprod Genet 2006;23:367-76. https://doi.org/10.1007/s10815-006-9066-9
  4. Robinson L, Gallos ID, Conner SJ, Rajkhowa M, Miller D, Lewis S, et al. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Hum Reprod 2012;27:2908-17. https://doi.org/10.1093/humrep/des261
  5. Zhao J, Zhang Q, Wang Y, Li Y. Whether sperm deoxyribonucleic acid fragmentation has an effect on pregnancy and miscarriage after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis. Fertil Steril 2014;102:998-1005.e8. https://doi.org/10.1016/j.fertnstert.2014.06.033
  6. Zhang Z, Zhu L, Jiang H, Chen H, Chen Y, Dai Y. Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: a meta-analysis. J Assist Reprod Genet 2015;32:17-26. https://doi.org/10.1007/s10815-014-0374-1
  7. Osman A, Alsomait H, Seshadri S, El-Toukhy T, Khalaf Y. The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: a systematic review and meta-analysis. Reprod Biomed Online 2015;30:120-7. https://doi.org/10.1016/j.rbmo.2014.10.018
  8. Kim SK, Jee BC, Kim SH. Histone methylation and acetylation in ejaculated human sperm: effects of swim-up and smoking. Fertil Steril 2015;103:1425-31. https://doi.org/10.1016/j.fertnstert.2015.03.007
  9. Dar S, Grover SA, Moskovtsev SI, Swanson S, Baratz A, Librach CL. In vitro fertilization-intracytoplasmic sperm injection outcome in patients with a markedly high DNA fragmentation index (>50%). Fertil Steril 2013;100:75-80. https://doi.org/10.1016/j.fertnstert.2013.03.011
  10. Jin J, Pan C, Fei Q, Ni W, Yang X, Zhang L, et al. Effect of sperm DNA fragmentation on the clinical outcomes for in vitro fertilization and intracytoplasmic sperm injection in women with different ovarian reserves. Fertil Steril 2015;103:910-6. https://doi.org/10.1016/j.fertnstert.2015.01.014
  11. Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, Abad C, Amengual MJ, Prada E, et al. Comprehensive analysis of sperm DNA fragmentation by five different assays: UNEL assay, SCSA, SCD test and alkaline and neutral Comet assay. Andrology 2013;1:715-22. https://doi.org/10.1111/j.2047-2927.2013.00111.x
  12. Lin MH, Kuo-Kuang Lee R, Li SH, Lu CH, Sun FJ, Hwu YM. 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. Fertil Steril 2008;90:352-9. https://doi.org/10.1016/j.fertnstert.2007.06.018
  13. Velez de la Calle JF, Muller A, Walschaerts M, Clavere JL, Jimenez C, Wittemer C, et al. Sperm deoxyribonucleic acid fragmentation as assessed by the sperm chromatin dispersion test in assisted reproductive technology programs: results of a large prospective multicenter study. Fertil Steril 2008;90:1792-9. https://doi.org/10.1016/j.fertnstert.2007.09.021
  14. Chi HJ, Chung DY, Choi SY, Kim JH, Kim GY, Lee JS, et al. Integrity of human sperm DNA assessed by the neutral comet assay and its relationship to semen parameters and clinical outcomes for the IVF-ET program. Clin Exp Reprod Med 2011;38:10-7. https://doi.org/10.5653/cerm.2011.38.1.10
  15. Esbert M, Pacheco A, Vidal F, Florensa M, Riqueros M, Ballesteros A, et al. Impact of sperm DNA fragmentation on the outcome of IVF with own or donated oocytes. Reprod Biomed Online 2011;23:704-10. https://doi.org/10.1016/j.rbmo.2011.07.010
  16. Simon L, Brunborg G, Stevenson M, Lutton D, McManus J, Lewis SE. Clinical significance of sperm DNA damage in assisted reproduction outcome. Hum Reprod 2010;25:1594-608. https://doi.org/10.1093/humrep/deq103
  17. Wang M, Sun J, Wang L, Gao X, Lu X, Wu Z, et al. Assessment of density gradient centrifugation (DGC) and sperm chromatin dispersion (SCD) measurements in couples with male factor infertility undergoing ICSI. J Assist Reprod Genet 2014;31:1655-63. https://doi.org/10.1007/s10815-014-0339-4
  18. Pregl Breznik B, Kovacic B, Vlaisavljevic V. Are sperm DNA fragmentation, hyperactivation, and hyaluronan-binding ability predictive for fertilization and embryo development in in vitro fertilization and intracytoplasmic sperm injection? Fertil Steril 2013;99:1233-41. https://doi.org/10.1016/j.fertnstert.2012.11.048
  19. Ahmadi A, Ng SC. Fertilizing ability of DNA-damaged spermatozoa. J Exp Zool 1999;284:696-704. https://doi.org/10.1002/(SICI)1097-010X(19991101)284:6<696::AID-JEZ11>3.0.CO;2-E
  20. Tesarik J, Greco E, Mendoza C. Late, but not early, paternal effect on human embryo development is related to sperm DNA fragmentation. Hum Reprod 2004;19:611-5. https://doi.org/10.1093/humrep/deh127
  21. Sakkas D, D'Arcy Y, Percival G, Sinclair L, Afnan M, Sharif K. Use of the egg-share model to investigate the paternal influence on fertilization and embryo development after in vitro fertilization and intracytoplasmic sperm injection. Fertil Steril 2004;82:74-9. https://doi.org/10.1016/j.fertnstert.2003.11.054
  22. Seli E, Gardner DK, Schoolcraft WB, Moffatt O, Sakkas D. Extent of nuclear DNA damage in ejaculated spermatozoa impacts on blastocyst development after in vitro fertilization. Fertil Steril 2004;82:378-83. https://doi.org/10.1016/j.fertnstert.2003.12.039
  23. Meseguer M, Santiso R, Garrido N, Garcia-Herrero S, Remohi J, Fernandez JL. Effect of sperm DNA fragmentation on pregnancy outcome depends on oocyte quality. Fertil Steril 2011;95:124-8. https://doi.org/10.1016/j.fertnstert.2010.05.055

피인용 문헌

  1. Effect of Sperm DNA Fragmentation on Embryo Quality in Normal Responder Women in In Vitro Fertilization and Intracytoplasmic Sperm Injection vol.60, pp.5, 2019, https://doi.org/10.3349/ymj.2019.60.5.461
  2. ALWAYS ICSI? A SWOT analysis vol.37, pp.9, 2017, https://doi.org/10.1007/s10815-020-01836-0
  3. PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial vol.37, pp.10, 2020, https://doi.org/10.1007/s10815-020-01913-4
  4. Effects of testicular sperm aspiration upon first cycle ICSI-ET for type 2 diabetic male patients vol.66, pp.6, 2020, https://doi.org/10.1080/19396368.2020.1785042
  5. The Author Reply: Effect of Sperm DNA Fragmentation on Embryo Quality in Normal Responder Women in IVF and ICSI vol.61, pp.11, 2020, https://doi.org/10.3349/ymj.2020.61.11.988
  6. DNA fragmentation index (DFI) as a measure of sperm quality and fertility in mice vol.10, pp.None, 2020, https://doi.org/10.1038/s41598-020-60876-9
  7. Clinical implications of sperm DNA damage in IVF and ICSI : updated systematic review and meta‐analysis vol.96, pp.4, 2017, https://doi.org/10.1111/brv.12700