Ajayi Abayomi Bolaji, Ajayi Victor, Osuolale Kazeem Adewale, Obi Ngozi, Obasa-Gbadebo Roselyn, Balogun Toluwanimi, Alaka Anuoluwa, Musa Olaoluwa, Omokhegbele Edith
Nordica Fertility Centre, Lagos, Nigeria.
Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.
BMC Urol. 2025 Aug 9;25(1):198. doi: 10.1186/s12894-025-01883-8.
Sperm DNA fragmentation detection methods include SCSA, SCD, COMET assay, and TUNEL. In 2021, the DFI test became the first evidence-based sperm DNA integrity test included in international guidelines. However, limited data exists from Nigeria. This study explores the relationship between demographic, lifestyle, and medical factors and DFI among infertility patients at Nordica Fertility Centre, aiming to guide interventions to improve fertility outcomes.
A total of 643 male infertility patients undergoing DFI analysis were evaluated. Participants were categorized based on age, occupation, BMI, alcohol use, smoking habits, and ejaculation frequency. The DFI was assessed both continuously and categorically using a 25% threshold (≤ 25% good, > 25% poor integrity). Chi-square tests examined associations between categorical variables while t-test was also used to examine significant association in terms of mean comparisons between DFI and other variables. Logistic regression analysis, with forward stepwise selection, identified independent predictors of high DFI, adjusting for potential confounders.
Participants had a mean age of 44.1 years; 55.7% were under 45. Most were professionals (57.1%) with a mean BMI of 27.5 kg/m². Alcohol use was reported by 45.2% and smoking by 9.6%. Mean DFI was 37.8% (range: 6-93%). Higher DFI was significantly associated with older age (χ²=12.21, p = 0.001), non-professional occupation (χ²=162.75, p < 0.001), and poor sperm motility (χ²=5.724, p = 0.017). Logistic regression showed that age above 45 years (OR = 2.45, 95% CI: 1.39-4.32, p = 0.002), occupation category (Professional/Technical/Managerial/ Clerical) (OR = 0.001, 95% CI: 0.0001-0.011, p < 0.001), and alcohol use (OR = 18.01, 95% CI: 7.03-46.12, p < 0.001) were independently associated with the outcome.
Older age, alcohol consumption, Professional/Technical/Managerial/ Clerical occupations, and alcohol use are associated with increased sperm DNA fragmentation. These findings highlight the need for personalized fertility assessments and targeted interventions to enhance male reproductive health.
精子DNA碎片化检测方法包括精子染色质结构分析（SCSA）、精子染色质扩散试验（SCD）、彗星试验和末端脱氧核苷酸转移酶介导的缺口末端标记法（TUNEL）。2021年，DNA碎片化指数（DFI）检测成为国际指南中首个基于证据的精子DNA完整性检测方法。然而，来自尼日利亚的数据有限。本研究探讨了人口统计学、生活方式和医学因素与诺迪卡生育中心不育患者DFI之间的关系，旨在指导干预措施以改善生育结局。
对643名接受DFI分析的男性不育患者进行了评估。参与者根据年龄、职业、体重指数（BMI）、饮酒情况、吸烟习惯和射精频率进行分类。使用25%的阈值（≤25%为良好，>25%为完整性差）对DFI进行连续和分类评估。卡方检验用于检验分类变量之间的关联，t检验也用于检验DFI与其他变量之间均值比较的显著关联。采用向前逐步选择的逻辑回归分析，确定高DFI的独立预测因素，并对潜在混杂因素进行调整。
参与者的平均年龄为44.1岁；55.7%的人年龄在45岁以下。大多数人是专业人员（57.1%），平均BMI为27.5kg/m²。45.2%的人报告有饮酒习惯，9.6%的人吸烟。平均DFI为37.8%（范围：6%-93%）。较高的DFI与年龄较大（χ²=12.21，p=0.001）、非专业职业（χ²=162.75，p<0.001）和精子活力差（χ²=5.724，p=0.017）显著相关。逻辑回归显示，45岁以上（比值比[OR]=2.45，95%置信区间[CI]：1.39-4.32，p=0.002）、职业类别（专业/技术/管理/文职）（OR=0.001，95%CI：0.0001-0.011，p<0.001）和饮酒（OR=18.01，95%CI：7.03-46.12，p<0.001）与结果独立相关。
年龄较大、饮酒、专业/技术/管理/文职职业以及饮酒与精子DNA碎片化增加有关。这些发现凸显了进行个性化生育评估和针对性干预以促进男性生殖健康的必要性。
