The Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia 23507, USA.
Fertil Steril. 2010 Jul;94(2):549-57. doi: 10.1016/j.fertnstert.2009.02.050. Epub 2009 Apr 1.
To evaluate DNA fragmentation in morphologically normal sperm recovered from the same sample used for intracytoplasmic sperm injection (ICSI) and to correlate DNA damage with embryo quality and pregnancy outcome.
Prospective study.
Academic center.
PATIENT(S): 36 infertile men participating in the ICSI program.
INTERVENTION(S): Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-fluorescein nick end labeling (TUNEL) assay and morphologic assessment by phase contrast.
MAIN OUTCOME MEASURE(S): Simultaneous assessment of sperm morphology and DNA fragmentation by TUNEL assay was performed in the same cell, then the percentage of normal sperm with fragmented DNA (normal SFD) was correlated with embryo quality and pregnancy outcomes.
RESULT(S): A highly statistically significant negative correlation was found between the percentage of normal SFD and embryo quality. This association was confirmed for the transferred embryos and for the total embryo cohort. The receiver operating characteristics curve analysis demonstrated that the percentage of normal SFD and embryo quality were statistically significant predictors of pregnancy. When the percentage of normal SFD was <or=17.6 %, the likelihood of pregnancy was 3.5 times higher. No correlation was found between the percentage of total sperm with fragmented DNA (morphologically normal and abnormal) and ICSI outcomes.
CONCLUSION(S): The DNA fragmentation of morphologically normal sperm negatively impacts embryo quality and probability of pregnancy in ICSI cycles.
评估从用于胞浆内单精子注射（ICSI）的同一样本中回收的形态正常精子的 DNA 碎片化，并将 DNA 损伤与胚胎质量和妊娠结局相关联。
前瞻性研究。
学术中心。
36 名参与 ICSI 计划的不育男性。
末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸-荧光素缺口末端标记（TUNEL）检测和相差显微镜下的形态评估。
通过 TUNEL 检测同时评估精子形态和 DNA 碎片化，在同一细胞中进行，然后将具有碎片化 DNA 的正常精子百分比（正常 SFD）与胚胎质量和妊娠结局相关联。
正常 SFD 的百分比与胚胎质量之间存在高度统计学显著的负相关。这种关联在转移胚胎和总胚胎队列中得到了证实。受试者工作特征曲线分析表明，正常 SFD 的百分比和胚胎质量是妊娠的统计学显著预测因子。当正常 SFD 的百分比<或=17.6%时，妊娠的可能性增加 3.5 倍。总精子 DNA 碎片化百分比（形态正常和异常）与 ICSI 结果之间无相关性。
形态正常精子的 DNA 碎片化会对 ICSI 周期中的胚胎质量和妊娠概率产生负面影响。
