Saleh Ramadan A, Agarwal Ashok, Nada Essam A, El-Tonsy Mohamed H, Sharma Rakesh K, Meyer Andrew, Nelson David R, Thomas Anthony J
Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Urological Institute, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Fertil Steril. 2003 Jun;79 Suppl 3:1597-605. doi: 10.1016/s0015-0282(03)00337-6.
To examine the effects of increased sperm DNA damage in relation to seminal oxidative stress in men with idiopathic and male factor infertility. Prospective study.
Infertility clinic at a tertiary care academic institution.
PATIENT(S): Ninety-two infertile men with normal female partners. Sixteen fertile donors served as the control group.
INTERVENTION(S): Standard semen analysis and assessment of levels of seminal oxidative stress. Assisted reproductive techniques in 33 of the 92 patients (IUI [n = 19], IVF [n = 10], and intracytoplasmic sperm injection [n = 4]).
MAIN OUTCOME MEASURE(S): Sperm DNA damage by sperm chromatin structure assay. Results were expressed as DNA fragmentation index.
RESULT(S): Patients were classified as having either idiopathic (n = 23) or male factor infertility (n = 69). Patients with idiopathic and male factor infertility had significantly higher DNA fragmentation index and oxidative stress compared with the case of fertile donors. A clinical pregnancy was achieved in 9 (27%) of 33 patients with assisted reproductive techniques. Significantly higher DNA fragmentation index and oxidative stress were found in men who failed to initiate a pregnancy after assisted reproductive techniques (n = 24), compared with the cases of those who succeeded and of the fertile donors. DNA fragmentation index was correlated positively with oxidative stress (r = 0.27), and negatively with fertilization (r = -0.70) and embryo quality (r = -0.70).
CONCLUSION(S): Sperm DNA damage is significantly increased in men with idiopathic and male factor infertility and in men who failed to initiate a pregnancy after assisted reproductive techniques. Such an increase may be related to high levels of seminal oxidative stress.
研究特发性及男性因素所致不育男性精子DNA损伤增加与精液氧化应激之间的关系。前瞻性研究。
一家三级医疗学术机构的不孕不育诊所。
92名不育男性，其女性伴侣均正常。16名有生育能力的捐赠者作为对照组。
标准精液分析及精液氧化应激水平评估。92名患者中的33名接受辅助生殖技术（宫腔内人工授精 [n = 19]、体外受精 [n = 10] 和卵胞浆内单精子注射 [n = 4]）。
采用精子染色质结构分析检测精子DNA损伤。结果以DNA碎片指数表示。
患者分为特发性不育（n = 23）和男性因素不育（n = 69）。与有生育能力的捐赠者相比，特发性不育和男性因素不育患者的DNA碎片指数及氧化应激水平显著更高。33名接受辅助生殖技术的患者中有9名（27%）实现了临床妊娠。与成功妊娠的患者及有生育能力的捐赠者相比，辅助生殖技术后未成功妊娠的男性（n = 24）的DNA碎片指数及氧化应激水平显著更高。DNA碎片指数与氧化应激呈正相关（r = 0.27），与受精率（r = -0.70）及胚胎质量（r = -0.70）呈负相关。
特发性及男性因素所致不育男性以及辅助生殖技术后未成功妊娠的男性精子DNA损伤显著增加。这种增加可能与精液氧化应激水平升高有关。
