Rios Julie S, Coward R Matthew, Hansen Karl R, Barnhart Kurt T, Cedars Marcelle I, Legro Richard S, Diamond Michael P, Krawetz Stephen A, Usadi Rebecca, Baker Valerie L, Sun Fangbai, Wild Robert, Smith James F, Santoro Nanette, Zhang Heping, Steiner Anne Z
University of Cincinnati College of Medicine, Cincinnati, Ohio.
University of North Carolina, Chapel Hill, North Carolina.
F S Rep. 2021 Jun 19;2(3):282-288. doi: 10.1016/j.xfre.2021.06.003. eCollection 2021 Sep.
To examine the factors associated with increased deoxyribonucleic acid fragmentation index (DFI), evaluate the pregnancy outcomes of men with increased DFI, and compare three independent DFI assays.
Secondary analysis.
Nine US-based fertility centers.
Infertile men (N = 147) with sperm concentration ≤15 × 10/mL, motility ≤40%, or normal morphology ≤4% were enrolled. The female partners were ovulatory, ≤40 years old, and had documented tubal patency.
At a baseline visit, the men provided a semen sample. The couples attempted conception without assistance for 3 months and with ovarian stimulation and intrauterine insemination in the subsequent 3 months.
The DFI was analyzed using the sperm chromatin structure assay (SCSA) with increased DFI defined as >30%. The predictors of increased DFI were determined by a multivariable linear regression model. The pregnancy outcomes were compared using the χ test. The independent DFI assays (SCSA, deoxynucleotidyl transferase-mediated dUTP nick end labeling, and Comet) were compared with Pearson and Spearman correlations.
The 19% of men with increased DFI were older (36.0 vs. 33.0 years) and had lower total sperm motility (38.2% ± 20.5% vs. 45.2% ± 15.6%). Increased male age was found to be a significant predictor of DFI (0.75, 95% confidence interval [0.06, 1.45]). Increased DFI was not associated with conception or live birth. There was a modest correlation of the deoxynucleotidyl transferase-mediated dUTP nick end labeling assay with the SCSA (r = 0.34) and Comet assay (r = 0.19).
Older age was associated with increased DFI among infertile men. The DFI assays were only weakly correlated, indicating a standard definition of DFI is needed to truly interrogate how sperm deoxyribonucleic acid fragmentation impacts male fertility.
研究与脱氧核糖核酸碎片化指数（DFI）升高相关的因素，评估DFI升高男性的妊娠结局，并比较三种独立的DFI检测方法。
二次分析。
美国的9个生育中心。
纳入精子浓度≤15×10/mL、活力≤40%或正常形态≤4%的不育男性（N = 147）。其女性伴侣有排卵功能，年龄≤40岁，输卵管通畅有记录。
在基线访视时，男性提供精液样本。夫妻双方先尝试自然受孕3个月，随后3个月进行卵巢刺激和宫内人工授精。
使用精子染色质结构分析（SCSA）分析DFI，DFI升高定义为>30%。通过多变量线性回归模型确定DFI升高的预测因素。使用χ检验比较妊娠结局。通过Pearson和Spearman相关性比较独立的DFI检测方法（SCSA、脱氧核苷酸转移酶介导的dUTP缺口末端标记法和彗星试验）。
DFI升高的男性中有19%年龄较大（36.0岁对33.0岁），总精子活力较低（38.2%±20.5%对45.2%±15.6%）。男性年龄增加是DFI的显著预测因素（0.75，95%置信区间[0.06，1.45]）。DFI升高与受孕或活产无关。脱氧核苷酸转移酶介导的dUTP缺口末端标记法与SCSA（r = 0.34）和彗星试验（r = 0.19）有适度相关性。
年龄较大与不育男性的DFI升高有关。DFI检测方法之间的相关性较弱，这表明需要一个DFI的标准定义，以真正探究精子脱氧核糖核酸碎片化如何影响男性生育能力。
