Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Endocrinol (Lausanne). 2024 Apr 8;15:1289763. doi: 10.3389/fendo.2024.1289763. eCollection 2024.
Male sperm DNA fragmentation (SDF) may be associated with assisted reproductive technology (ART) outcomes, but the impact of SDF on the occurrence of aneuploid-related miscarriage remains controversial.
Genome-wide single-nucleotide polymorphism-based chromosomal microarray analysis was performed on 495 miscarried chorionic villus samples undergone IVF/ICSI treatment from the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University. SDF was assessed using sperm chromatin structure assay. Patients were divided into four groups according to embryo transfer cycle type and maternal age, and the correlation between SDF and chromosome aberration was analyzed. A receiver operating characteristic (ROC) curve was utilized to find the optimal threshold.
Total chromosomal aneuploidy rate was 54.95%, and trisomy was the most common abnormality (71.32%). The chromosomally abnormal group had higher SDF than the normal group (11.42% [6.82%, 16.54%] vs. 12.95% [9.61%, 20.58%], = 0.032). After grouping, elevated SDF was significantly correlated with an increasing chromosome aneuploidy rate only in women of advanced age who underwent fresh embryo transfer (adjusted odds ratio:1.14 [1.00-1.29], adjusted- = 0.045). The receiver operating characteristic curve showed that SDF can predict the occurrence of chromosomal abnormality of miscarried conceptus in this group ((area under the curve = 0.76 [0.60-0.91], = 0.005), and 8.5% was the optimum threshold. When SDF was ≥ 8.5%, the risk of such patients increased by 5.76 times (adjusted odds ratio: 6.76 [1.20-37.99], adjusted- = 0.030).
For women of advanced maternal age undergoing fresh embryo transfer, older oocytes fertilized using sperm with high SDF in IVF/ICSI treatment might increase the risk of chromosomal abnormality in miscarried conceptus.
男性精子 DNA 碎片化（SDF）可能与辅助生殖技术（ART）结局相关，但 SDF 对与非整倍体相关的流产发生的影响仍存在争议。
对郑州大学第一附属医院生殖医学中心行 IVF/ICSI 治疗后发生自然流产的 495 例绒毛组织样本进行全基因组 SNP 芯片分析。采用精子染色质结构分析（SCSA）评估 SDF。根据胚胎移植周期类型和产妇年龄将患者分为四组，分析 SDF 与染色体异常的相关性。采用受试者工作特征（ROC）曲线寻找最佳阈值。
总染色体非整倍体率为 54.95%，三体最为常见（71.32%）。染色体异常组的 SDF 高于正常组（11.42%[6.82%，16.54%]比 12.95%[9.61%，20.58%]， = 0.032）。分组后，仅在接受新鲜胚胎移植的高龄女性中，高 SDF 与染色体非整倍体率的升高显著相关（调整后的比值比：1.14[1.00-1.29]，调整后的 = 0.045）。ROC 曲线显示，SDF 可预测该组流产胚胎染色体异常的发生（曲线下面积=0.76[0.60-0.91]， = 0.005），8.5%为最佳阈值。当 SDF≥8.5%时，此类患者的风险增加 5.76 倍（调整后的比值比：6.76[1.20-37.99]，调整后的 = 0.030）。
对于接受新鲜胚胎移植的高龄产妇，IVF/ICSI 治疗中高龄卵子与高 SDF 精子受精可能会增加流产胚胎染色体异常的风险。
