Reproductive Medicine Associates of Southern California, 11500 West Olympic Boulevard, Suite 150, Los Angeles, CA, 90064, USA.
Reproductive Medicine Associates of Florida, 400 Colonial Center Parkway, Suite 150, Lake Mary, FL, 32746, USA.
J Assist Reprod Genet. 2020 Jan;37(1):71-76. doi: 10.1007/s10815-019-01632-5. Epub 2019 Nov 21.
To evaluate if sperm DNA fragmentation (SDF) in the sample used for intracytoplasmic sperm injection (ICSI) impacts outcomes after euploid blastocyst transfer.
Prospective cohort study of couples undergoing IVF with preimplantation genetic testing for aneuploidy from December 2014-June 2017. Sperm collected on the day of ICSI was analyzed for SDF using the sperm chromatin structure assay (SCSA®). Semen analysis parameters, embryologic outcomes, and clinical outcomes after euploid blastocyst transfer were compared between groups with DNA fragmentation index (DFI) ≤ 15% and DFI > 15% using Mann-Whitney U, t tests, and generalized linear mixed effects models.
Two hundred thirty-four patients were included. One hundred seventy-nine men had DFI ≤ 15% (low DFI group) and 55 men had DFI > 15% group (high DFI group). Total motile sperm and sperm concentration were significantly lower in the group with DFI > 15% vs. DFI ≤ 15%. There was no difference in fertilization (86.3 vs. 84.2%, adjusted OR (95% CI) 0.86 (0.63-1.18)), blastulation (49.5 vs. 48.8%, adjusted OR 1.02 (0.75-1.36)), or euploidy (55.7 vs. 52.1%, adjusted OR 0.96 (0.7-1.31)) between the low and high DFI groups, respectively. Clinical outcomes were similar between low and high DFI groups, including implantation rate (68.8 vs. 79.8%), ongoing pregnancy rate (65.9 vs. 72.6%), and miscarriage rate (4.2 vs. 8.8%), respectively.
Sperm DNA fragmentation on the day of ICSI is not associated with embryologic or clinical outcomes after euploid blastocyst transfer. Increasing levels of SDF are associated with low sperm concentration and total motile sperm count.
评估卵胞浆内单精子注射（ICSI）中使用的精子 DNA 碎片（SDF）是否会影响整倍体囊胚移植后的结局。
这是一项 2014 年 12 月至 2017 年 6 月进行的前瞻性队列研究，研究对象为接受植入前胚胎遗传学检测整倍体的体外受精夫妇。使用精子染色质结构分析（SCSA®）对 ICSI 当天收集的精子进行 SDF 分析。使用 Mann-Whitney U 检验、t 检验和广义线性混合效应模型比较 DNA 碎片指数（DFI）≤15%和 DFI＞15%两组的精子分析参数、胚胎学结局和整倍体囊胚移植后的临床结局。
共纳入 234 例患者。179 例男性的 DFI≤15%（低 DFI 组），55 例男性的 DFI＞15%（高 DFI 组）。DFI＞15%组的总活动精子和精子浓度明显低于 DFI≤15%组。两组的受精率（86.3% vs. 84.2%，调整后的 OR（95%CI）0.86（0.63-1.18））、囊胚形成率（49.5% vs. 48.8%，调整后的 OR 1.02（0.75-1.36））和整倍体率（55.7% vs. 52.1%，调整后的 OR 0.96（0.7-1.31））均无差异。低 DFI 组和高 DFI 组的临床结局相似，包括着床率（68.8% vs. 79.8%）、持续妊娠率（65.9% vs. 72.6%）和流产率（4.2% vs. 8.8%）。
ICSI 当天的精子 DNA 碎片与整倍体囊胚移植后的胚胎学或临床结局无关。SDF 水平升高与精子浓度和总活动精子计数低有关。
