Yifu Pu, Lei Yan, Shaoming Lu, Yujin Guo, Xingwang Zhu
Reproductive Hospital Affiliated to Shan Dong University, Jinan, China.
Reproductive Hospital Affiliated to Shan Dong University, Jinan, China; School of Medicine, Shan Dong University, No. 44 Wenhuaxi RD, Jinan, 250000, Shan Dong Province, China.
J Gynecol Obstet Hum Reprod. 2020 Apr 26:101740. doi: 10.1016/j.jogoh.2020.101740.
A high sperm DNA fragmentation index (DFI) influences human reproduction and is observed in infertile men. However, the influence of DFI on unexplained recurrent spontaneous abortion (RSA) remains controversial.
We explored the influence of DFI on unexplained recurrent spontaneous abortion.
We conducted a meta-analysis of DFI (assessed by sperm chromatin structure assay(SCSA), terminal deoxynucleotidyl transferase-mediated deoxyuridine (TdT)triphosphate (dUTP) nick end labeling assay(TUNEL), sperm chromatin dispersion(SCD), single cell gel electrophoresis assay(COMET assay), and acridine orange test(AOT) with unexplained RSA from the Cochrane Library, EMBASE, Pubmed and Web of Science database.
Records were screened for eligible studies and data were extracted to an online data extraction form. The main outcome was the sperm DFI. Summary measures were reported as the mean difference(MD) and Odds Ratio(OR) with 95 % confifidence interval (CI).
We identified 27 articles including 3, 2, 9, 9, and 8 studies using AO, COMET, SCSA, SCD and TUNEL respectively; 7 articles used qualitative methods and 21 articles used in quantitative methods. The combined MD estimates of 7 SCSA studies (MD=5.4; 95 % CI: 1.76-9.03; P<0.01), 9 SCD studies (MD=11.16; 95 % CI:6.70-15.62; P<0.01), and 8 TUNEL studies (MD=12.12; 95 % CI: 3.34-20.91; P<0.01) showed significant differences. Notably, qualitative studies showed consistent results with quantitative studies.
CONCLUSION(S): These findings support an association between sperm DFI and recurrent pregnancy loss. Previous studies revealed that DFI negatively impacts unexplained RSA.
精子DNA碎片化指数（DFI）较高会影响人类生殖，在不育男性中较为常见。然而，DFI对不明原因复发性自然流产（RSA）的影响仍存在争议。
探讨DFI对不明原因复发性自然流产的影响。
我们对来自Cochrane图书馆、EMBASE、Pubmed和Web of Science数据库中使用精子染色质结构分析（SCSA）、末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸（dUTP）缺口末端标记法（TUNEL）、精子染色质扩散法（SCD）、单细胞凝胶电泳法（彗星试验）和吖啶橙试验（AOT）评估DFI与不明原因RSA的研究进行了荟萃分析。
筛选符合条件的研究记录，并将数据提取到在线数据提取表中。主要结果是精子DFI。汇总测量结果以平均差（MD）和比值比（OR）及95%置信区间（CI）表示。
我们确定了27篇文章，其中分别有3、2、9、9和8项研究使用AO、彗星试验、SCSA、SCD和TUNEL；7篇文章使用定性方法，21篇文章使用定量方法。7项SCSA研究（MD = 5.4；95%CI：1.76 - 9.03；P < 0.01）、9项SCD研究（MD = 11.16；95%CI：6.70 - 15.62；P < 0.01）和8项TUNEL研究（MD = 12.12；95%CI：3.34 - 20.91；P < 0.01）的合并MD估计值显示出显著差异。值得注意的是，定性研究与定量研究结果一致。
这些发现支持精子DFI与复发性流产之间存在关联。先前的研究表明DFI对不明原因RSA有负面影响。
