[Impact of sperm DNA fragmentation index on embryonic development and live birth outcome of in vitro fertilization-embryo transfer].

OBJECTIVE

To investigate the effects of sperm DNA fragmentation index (DFI) on embryonic development and live birth outcomes of in vitro fertilization-fresh embryo transfer (IVF-ET).

METHODS

We selected 947 cases of IVF-ET due to female factors from June 2015 to December 2020 and, according to the DFI, divided them into a low- (DFI < 15%), a medium- (15 ≤ DFI ≤ 30%) and a high-DFI (30%<DFI) group. We obtained the female factors (including age, body mass index ［BMI］, and baseline levels of sexual hormones and anti-Müllerian hormone ［AMH］), male factors (including age, BMI, and semen parameters), parameters of superovulation induction, semen parameters before and after IVF treatment, outcome of ovulation induction, embryo quality and pregnancy outcome, and compared them among the three groups.

RESULTS

The patients in the medium- and high-DFI groups had a significantly older age than those in the low-DFI group. There were statistically significant differences among the three groups in the baseline percentages of progressively motile sperm, non-progressively motile sperm and immotile sperm, and total sperm motility and progressive sperm motility before IVF (P<0.01). The baseline percentage of morphologically normal sperm, sperm concentration and total sperm count before IVF treatment, and sperm concentration after IVF treatment were significantly lower in the medium- and high-DFI groups than in the low-DFI group, and so was the total sperm count in the high-DFI than in the low- and medium-DFI groups either before or after semen treatment (P<0.01). The fertilization rate was also markedly lower in the medium- and high-DFI than in the low-DFI group, but no statistically significant differences were observed in ovulation induction parameters, embryo quality and pregnancy outcome among the three groups.

CONCLUSION

High DFI significantly affects sperm motility. The DFI level after semen treatment is negatively correlated with sperm concentration, total sperm count and fertilization rate, but does not affect embryo quality and pregnancy outcome.