Sperm chromatin structure assay parameters are not related to fertilization rates, embryo quality, and pregnancy rates in in vitro fertilization and intracytoplasmic sperm injection, but might be related to spontaneous abortion rates

Objective: To investigate the relationship between sperm chromatin structure assay (SCSA) parameters, DNA fragmentation index (DFI) and high DNA stainability (14DS), and outcomes of fVF and intracytoplasmic sperm injection (ICSI). Design: Retrospective review and prospective study. Setting: Academic human reproduction laboratory. Patient(s): Two hundred twenty-three couples undergoing conventional lVF (n = t37) and ICS] (n = 86). Interventioll(S): Testing with SCSA on a semen aliquot taken from ejaculate used for assisted reproductive technology (ART). Main Outcome Measure(s): Conventional sernen parameters, DFI, HDS, outcornes of IVF and ICS1. Result(s): There were no significant differences in 1VF and ICSI fertilization rate, good embryo rate, and pregnancy rate (PR) between high, moderate, and low DF1 or HDS groups. Men with HDS > 15% had significantly higher IVF abortion rates. There was a statistically insignificant trend toward an increased abortion rate in the high DF1 (>27%) group. The DFI correlated negatively with sperm motility, and HDS correlated negatively with sperm morphology and concentration. Conclusion(S): Neither DFI nor RDS scores can provide independent information about embryo quality, fertilization, and PRs for infertility patients undergoing ART. Sperm DNA fragmentation probably affects sperm motility. The relationship between HDS and lVF abortion rates provides preliminary evidence that ICSI may be indicated for men with HDS > 15%. The potential adverse effect of sperm DNA dainage on the quality of postimplantation embryo and spontaneous abortion should be a concern.