Vinnakota Chitra, Cree Lynsey, Peek John, Morbeck Dean E
Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Fertility Associates, Auckland, New Zealand.
Syst Biol Reprod Med. 2019 Dec;65(6):451-457. doi: 10.1080/19396368.2019.1668077. Epub 2019 Sep 24.
Sperm DNA integrity is important for fertility, however the incidence of high levels of DNA fragmentation (DNA fragmentation index (DFI) >30%) is not well described. In 2011, our clinics implemented guidelines for sperm DNA fragmentation (SDF) testing based on risk factors using the sperm chromatin structure assay (SCSA). The aim of this retrospective study is to characterise SDF and associated factors (age, semen parameters, smoking status and BMI) for sub-fertile males (n = 1082) and sperm donors (n = 234). The average DFI was 12.1 ± 9.8%. The distribution of men with low, moderate and high SDF (<15, 15-30 and >30%) was 74.8%, 19.4% and 5.8%, respectively. Men with high DFI were older (45 ± 9.5 vs 38 ± 6.7) and had lower percentage of motile sperm (38.8 ± 16.1% vs 55.3 ± 15.8%) than men with normal DFI. Over 17% of the men in the quartile with the highest age and lowest motility had a high DFI (>30%), compared to a high DFI rate of 2-4% for the other 3 quartiles. Repeat testing following lifestyle interventions was available for 29 couples where the men had high initial DFI (35 ± 9.5%). Of these men, 71.4% had a decrease of DFI into the moderate or low range. This study shows that SDF testing can be targeted based on age and sperm motility, thereby reducing unnecessary testing. Furthermore, we provide evidence that lifestyle modifications can reduce DNA fragmentation in men with high DFI.
精子DNA完整性对生育能力很重要，然而，高水平DNA片段化（DNA片段化指数（DFI）>30%）的发生率尚未得到充分描述。2011年，我们的诊所实施了基于风险因素的精子DNA片段化（SDF）检测指南，采用精子染色质结构分析（SCSA）。这项回顾性研究的目的是描述亚生育男性（n = 1082）和精子捐献者（n = 234）的SDF及相关因素（年龄、精液参数、吸烟状况和BMI）。平均DFI为12.1±9.8%。SDF低、中、高（<15%、15 - 30%和>30%）的男性分布分别为74.8%、19.4%和5.8%。与DFI正常的男性相比，DFI高的男性年龄更大（45±9.5岁对38±6.7岁），活动精子百分比更低（38.8±16.1%对55.3±15.8%）。在年龄最大且活力最低的四分位数中，超过17%的男性DFI高（>30%），而其他三个四分位数的DFI高率为2 - 4%。29对夫妇中的男性初始DFI高（35±9.5%），在生活方式干预后进行了重复检测。在这些男性中
