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Sugihara A, Punjabi U, Chimienti T, Goovaerts I, Peeters K, Bouziotis J, De Neubourg D. Sperm DNA Fragmentation after Cryopreservation and Sperm Selection Has No Implications for Clinical Pregnancies and Live Births after Intrauterine Insemination with Donor Sperm. J Pers Med 2023; 13:1668. [PMID: 38138895 PMCID: PMC10745103 DOI: 10.3390/jpm13121668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
Intrauterine insemination with donor sperm (IUI-D) requires multiple in vitro manipulations such as sperm selection and cryopreservation during which spermatozoa may be exposed to oxidative stress (OS) and other insults that may produce potential damage including sperm DNA fragmentation (SDF). High levels of SDF, referring to damage or breaks in the genetic material of sperm cells, are linked to an increased risk of reproductive failure. This retrospective, observational study set out to evaluate whether SDF assessment could predict clinical outcome in an IUI-D program, where sperm donors are selected on strict conventional semen parameters. A total of 18 donors and 106 recipients were matched for IUI-D. Out of 429 cycles, 100 (23.3%) resulted in clinical pregnancy. We counted 78 live births (18.2% of cycles), while 20 pregnancies ended in miscarriage (4.7% of cycles), 1 in extra-uterine pregnancy and 1 in stillbirth. Female age significantly influenced clinical pregnancy and miscarriage rates. SDF increased after cryopreservation (26.3 ± 14.5%; p < 0.001) and more so after post-thaw density gradient (34.9 ± 22.1%; p = 0.04) without affecting clinical pregnancy (OR [95% CI] 1.01 [0.99; 1.02]; p = 0.27), live birth (1.00 [0.99; 1.02]; p = 0.72) and miscarriage rates (1.02 [1.00; 1.05]; p = 0.08). The implications of our findings extend to a better selection of sperm donors and a better sperm preparation technique tailored to the donor semen's properties in order to maximize the chances of a favorable treatment outcome.
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Affiliation(s)
- Alessa Sugihara
- Centre of Reproductive Medicine, University Hospital of Antwerp, 2650 Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp—Campus Drie Eiken, 2610 Wilrijk, Belgium
- Centre of Reproductive Medicine, Algemeen Ziekenhuis KLINA, 2930 Brasschaat, Belgium
| | - Usha Punjabi
- Centre of Reproductive Medicine, University Hospital of Antwerp, 2650 Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp—Campus Drie Eiken, 2610 Wilrijk, Belgium
| | - Tiziana Chimienti
- Centre of Reproductive Medicine, University Hospital of Antwerp, 2650 Edegem, Belgium
| | - Ilse Goovaerts
- Centre of Reproductive Medicine, University Hospital of Antwerp, 2650 Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp—Campus Drie Eiken, 2610 Wilrijk, Belgium
| | - Kris Peeters
- Centre of Reproductive Medicine, University Hospital of Antwerp, 2650 Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp—Campus Drie Eiken, 2610 Wilrijk, Belgium
| | - Jason Bouziotis
- Clinical Trial Center, University Hospital of Antwerp, 2650 Edegem, Belgium
| | - Diane De Neubourg
- Centre of Reproductive Medicine, University Hospital of Antwerp, 2650 Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp—Campus Drie Eiken, 2610 Wilrijk, Belgium
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