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Liu K, Mao X, Pan F, Chen Y, An R. Correlation analysis of sperm DNA fragmentation index with semen parameters and the effect of sperm DFI on outcomes of ART. Sci Rep 2023; 13:2717. [PMID: 36792684 PMCID: PMC9931767 DOI: 10.1038/s41598-023-28765-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/24/2023] [Indexed: 02/17/2023] Open
Abstract
Routine semen analysis provides limited information about a man's male reproductive potential and can not always fully explain male infertility. Many male infertilities are caused by sperm DNA defects that routine semen quality analyses fail to detect. In this study, we analyzed the association of sperm DNA fragmentation index (DFI) with the semen routine, sperm morphology, in vitro fertilization embryo transfer (IVF-ET)/intracytoplasmic sperm injection (ICSI). Further, we explored the predictive value of sperm DFI in evaluating male fertility and the outcome of IVF-ET/ICSI. Data on sperm DFI, sperm routine, and sperm morphology were collected from 1462 males with infertility. According to DFI levels, there were 468 cases in group I (DFI ≤ 15%), 518 cases in group II (15% < DFI < 30%), and 476 cases in group III (DFI ≥ 30%). The correlations of sperm DFI with semen routine and malformation rate were analyzed. Seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) were assessed. Sperm DFI, semen routine, and sperm morphology were detected in male patients of 101 pairs of IVF-ET/ICSI infertile couples and subdivided into IVF-I group (DFI ≤ 15%), IVF-II group (15% < DFI < 30%), IVF-III group (DFI ≥ 30%), ICSI-I group (DFI ≤ 15%), ICSI-II group (15% < DFI < 30%) and ICSI-III group (DFI ≥ 30%) according to DFI value. The effect of sperm DFI on the outcome of IVF-ET/ICSI was analyzed. There were significant differences in sperm survival rate, sperm concentration, and PR% between groupIII and group II (P < 0.01). There were significant differences in sperm survival rate, sperm concentration and PR% between group III and group I (P < 0.01). There was no significant difference in semen volume, age, abstinence days, or percentage of normal sperm between the three groups (P > 0.05). DFI was positively correlated with MDA content ( P < 0.01) and negatively correlated with TAC (P < 0.01). Sperm DFI was negatively correlated with sperm survival rate, sperm concentration, and PR% (P < 0.01). There was no correlation with age, abstinence days, semen volume, or percentage of normal-form sperm (r = 0.16, 0.05, 0.04, -0.18, p > 0.05). Compared with IVF-I group, the sperm concentration and PR were decreased in IVF-III group. The sperm malformation rate was higher in IVF-III group than that in IVF-II group. Comparatively, the PR was decreased in ICSI-III group. The sperm malformation rate was higher in ICSI-III group than that of the ICSI-I group (P < 0.05). There were no statistically significant differences in fertilization rate, cleavage rate, embryo rate, and clinical pregnancy rate between IVF group or ICSI group, and between all subgroups (P > 0.05). Sperm DFI is negatively associated with sperm survival rate, sperm concentration, and PR%. Antioxidants can decrease the rate of DNA fragmentation. Sperm DFI has proven to be very valuable in the male fertility evaluation, but its significance as a predictor of pregnancy outcomes following assisted reproductive technology. (ART) requires further investigation.
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Affiliation(s)
- KangSheng Liu
- grid.452438.c0000 0004 1760 8119Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shannxi China ,grid.459791.70000 0004 1757 7869Department of Clinical Laboratory, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210029 Jiangsu China
| | - XiaoDong Mao
- grid.410745.30000 0004 1765 1045Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028 Jiangsu China
| | - Feng Pan
- grid.459791.70000 0004 1757 7869Department of Andrology, State Key Laboratory of Reproductive Medicine, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210029 Jiangsu China
| | - YaJun Chen
- grid.459791.70000 0004 1757 7869Department of Clinical Laboratory, Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, 210029 Jiangsu China
| | - Ruifang An
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shannxi, China.
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Capra G, Notari T, Buttà M, Serra N, Rizzo G, Bosco L. Human Papillomavirus (HPV) Infection and Its Impact on Male Infertility. Life (Basel) 2022; 12:1919. [PMID: 36431054 PMCID: PMC9697777 DOI: 10.3390/life12111919] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Nowadays, the striking numbers of infertile couples that turn to assisted reproductive technologies (ART) drive the research toward a more comprehensive understanding of the underlying causes. Male factors contribute to the inability to conceive in half of the cases, and it has been suggested that sexually transmitted infections could have a role in the onset of spermatozoa impairments. Since the impact of HPV infection on sperm quality and sperm DNA integrity is debated, we wanted to analyze its impact on conventional seminal parameters and the sperm DNA fragmentation index (DFI). Therefore, 117 semen samples of patients undergoing IVF were evaluated for the following characteristics: HPV DNA detection and sperm DNA fragmentation, concentration, motility, and morphology. The results showed a higher rate of HPV-negative patients (59.8% vs. 40.2%) and no HPV-related effect on DFI, sperm concentration, total sperm number, and total motility. Only progressive motility and morphology were found as significantly influenced by HPV positivity. Moreover, we observed a statistically significant difference in DFI when comparing high-risk HPV (HR-HPV) and low-risk HPV (LR-HPV) genotypes. Our data suggest that the presence of any HPV type, whatever the exact localization of the virions, can impair some sperm parameters, while HR-HPVs specifically affect the integrity of spermatozoa DNA.
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Affiliation(s)
- Giuseppina Capra
- UOC of Microbiology and Virology, Polyclinic Hospital, Via del Vespro, 133, 90127 Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy
| | - Tiziana Notari
- “Check Up” Polydiagnostic and Research Laboratory, Andrology Unit, Viale Andrea De Luca 5, 84131 Salerno, Italy
- “D’Arena”—Clinical Analysis and Diagnostics Laboratory—Vallo della Lucania, Str. Giuseppe Garibaldi, 25/C-F, 84078 Salerno, Italy
| | - Michela Buttà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE) “G. D’Alessandro”, University of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, Italy
| | - Nicola Serra
- Department of Public Health, University Federico II of Naples, Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanni Rizzo
- “D’Arena”—Clinical Analysis and Diagnostics Laboratory—Vallo della Lucania, Str. Giuseppe Garibaldi, 25/C-F, 84078 Salerno, Italy
| | - Liana Bosco
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D), Section of Biology and Genetics, University of Palermo, 90133 Palermo, Italy
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Chen L, Fang J, Jiang W, Wang J, Li D. Effects of the sperm DNA fragmentation index on the clinical and neonatal outcomes of intracytoplasmic sperm injection cycles. J Ovarian Res 2020; 13:52. [PMID: 32359369 PMCID: PMC7196230 DOI: 10.1186/s13048-020-00658-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 04/27/2020] [Indexed: 11/16/2022] Open
Abstract
Background Most studies have mainly focused on the effects of the sperm DNA fragmentation index (DFI) on fertilization, embryonic developmental potential and aneuploidy, pregnancy and abortion rates after in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) and have remained controversial. However, few studies have reported the effects of sperm DFI on neonatal outcomes, including stillbirths, neonatal deaths, sex, gestational age, prematurity, birthweight, low birth weight (LBW) and birth defects in newborns. Our objective was to evaluate the effects of sperm DFI on the clinical and neonatal outcomes of ICSI cycles. Methods This retrospective study analysed a total of 2067 oocyte retrieval, 1139 transfer and 713 delivery cycles from conventional ICSI cycles, including 301, 469, and 214 live-born infants in groups segregated according to sperm DFI as the < 15%, 15–30% and > 30% groups, respectively. The clinical and neonatal outcomes were compared among the three groups. Results Sperm DFI did not significantly affect the rates of fertilization, clinical pregnancy, miscarriage or ongoing pregnancy. Sperm DFI did not increase the risk of stillbirths or neonatal deaths. The rates of stillbirths and neonatal deaths were not significantly different among the three groups. The sex, gestational age, prematurity, birthweight and LBW of newborns in the three groups were not significantly affected by sperm DFI. Moreover, sperm DFI did not increase the number of birth defects in children. Conclusions Sperm DFI did not affect the clinical or neonatal outcomes of ICSI cycles.
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Affiliation(s)
- Linjun Chen
- Reproductive Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan, Road 321#, Nanjing, 210008, People's Republic of China.
| | - Junshun Fang
- Reproductive Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan, Road 321#, Nanjing, 210008, People's Republic of China
| | - Weihua Jiang
- Reproductive Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan, Road 321#, Nanjing, 210008, People's Republic of China
| | - Jie Wang
- Reproductive Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan, Road 321#, Nanjing, 210008, People's Republic of China
| | - Dong Li
- Reproductive Medical Center, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Zhongshan, Road 321#, Nanjing, 210008, People's Republic of China
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Esteves SC, Agarwal A, Cho CL, Majzoub A. A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios. Transl Androl Urol 2017; 6:S734-S760. [PMID: 29082207 PMCID: PMC5643602 DOI: 10.21037/tau.2017.08.20] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Sperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF. Methods A search of papers published in response to the CPG entitled “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” was performed within the Translational Andrology and Urology (TAU) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as “supportive without reservation”, “supportive with reservation”, “not supportive” or “neutral”. We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the ‘Strengths-Weaknesses-Opportunities-Threats’ (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice. Results Fifty-eight fertility experts from six continents and twenty-two countries contributed commentaries. Overall, participants (87.9%; n=51) were supportive of the recommendations provided by the CPG on the utility of SDF testing based on clinical scenarios. The majority of participants made explicit remarks about both the clinical scenarios and SDF assays’ characteristics. Among ‘not supportive’ and ‘supportive with reservation’ participants, 75% (n=30/40) and 77.5% (n=31/40) expressed concerns related to technical limitations of SDF testing methods and clinical utility of the test in one or more clinical scenarios discussed in the CPG, respectively. The SWOT analysis revealed that the CPG provides a reasonable evidence-based proposal for integration of SDF testing in the routine daily practice. It also uncovered gaps of knowledge and threats limiting the widespread application of SDF in everyday practice, thus allowing the identification of opportunities to further refine SDF testing and its clinical utility. Conclusions The understanding of the role of SDF in male infertility requires an in-depth analysis of the multifactorial pathophysiological processes and the theories involved. The SWOT analysis allowed an objective evaluation of CPG on the clinical utility of SDF testing based on clinical scenarios and its accompanying commentaries written by global experts in all possible angles. Implementation of SDF testing in the clinic may not only increase the outcome of ART but more importantly improve the health of both fathers to be and resulting offspring.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.,Division of Urology, Department of Surgery, Universtity of Campinas (UNICAMP), SP, Brazil.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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