Erenpreiss Juris, Elzanaty Saad, Giwercman Aleksander
Andrology Laboratory, Riga Stradins University, LV 1007 Riga, Latvia.
Asian J Androl. 2008 Sep;10(5):786-90. doi: 10.1111/j.1745-7262.2008.00417.x.
To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters.
A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay (SCSA) were carried out.
Ninety-seven men (28% of the whole study group) had a DNA fragmentation index (DFI)> 20%, and 43 men (12%) had a DFI>30%. In the group of men with abnormal semen parameters (n = 224), 35% had a DFI>20%, and 16% had a DFI>30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters (n=126). Men with low sperm motility and abnormal morphology had significantly higher odds ratios (ORs) for having a DFI>20% (4.0 for motility and 1.9 for morphology) and DFI>30% (6.2 for motility and 2.8 for morphology) compared with men with normal sperm motility and morphology.
In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique (ART).
调查精液参数正常和异常的不育夫妇男方中精子DNA高水平损伤的患病率。
对350对不育夫妇的男方进行评估。进行标准精液分析和精子染色质结构分析（SCSA）。
97名男性（占整个研究组的28%）的DNA碎片化指数（DFI）>20%，43名男性（12%）的DFI>30%。在精液参数异常的男性组（n = 224）中，35%的DFI>20%，16%的DFI>30%，而在精液参数正常的男性组（n = 126）中，这些数字分别为15%和5%。与精子活力和形态正常的男性相比，精子活力低和形态异常的男性DFI>20%（活力方面的比值比为4.0，形态方面为1.9）以及DFI>30%（活力方面为6.2，形态方面为2.8）的比值比显著更高。
在几乎三分之一未经过筛选的不育夫妇男方中，DFI超过了20%的水平，根据先前的研究，超过该水平会降低体内生育能力。相当一部分精液参数原本正常的男性也有高精子DNA损伤水平。因此，在精液分析未显示任何异常的情况下，SCSA检测有助于解释不孕原因。我们还建议进行SCSA检测以选择合适的辅助生殖技术（ART）。
