Sperm DNA fragmentation index and high DNA stainability do not influence pregnancy success after intracytoplasmic sperm injection.

OBJECTIVE

To evaluate the ability of sperm DNA fragmentation index (DFI%) and high DNA stainability (HDS%) to influence the chance of achieving pregnancy in couples undergoing intracytoplasmic sperm injection (ICSI) cycles.

DESIGN

A retrospective study evaluating couples that underwent an ICSI cycle between 2009 - 2018.

SETTING

High-volume reproductive center.

PATIENTS

Consecutive couples who underwent an ICSI cycle and had a semen analysis with subsequent DFI% and HDS% testing, evaluated by Sperm Chromatin Structure Assay (SCSA).

INTERVENTIONS

Measurement of DFI% and HDS% prior to ICSI cycle.

MAIN OUTCOME MEASURES

To determine whether DFI% or HDS% of sperm was predictive of the number of ICSI cycles until the first clinical intrauterine pregnancy.

RESULTS

A total of 550 couples who underwent 1050 ICSI cycles were analyzed. Of those, a total of 330 couples achieved pregnancy. As expected, in couples that achieved pregnancy, females were younger (33.7 ± 3.6 years vs 35.3 ± 3.4 years; p < 0.001) and underwent fewer cycles (2 [1-2] vs 2 [1-3]; p =0.001). Importantly, the DFI% and HDS% were similar between couples who achieved pregnancy (DFI% = 12.9 [8-20]; HDS% = 9.3 [6.1-14.6]) and couples who did not (DFI% =12.2 [7.1-20.2]; HDS% = 9.1 [6.7-14]). A multivariable-adjusted analysis evaluating female age at the first cycle was negatively associated with pregnancy (OR = 0.827, 95% CI: 0.778 - 0.879; p < 0.001).

CONCLUSIONS

Neither DFI nor HDS at baseline influence the chances of a couple to achieve pregnancy after ICSI. Increased female age and couples who underwent more ICSI cycles were associated with lower chances of achieving pregnancy.