Impact of sperm DNA fragmentation on the clinical outcome of assisted reproduction techniques: a systematic review of the last five years

Abstract

Objective: To elucidate through a systematic literature review the impact sperm DNA fragmentation has on embryos from assisted reproduction techniques. Data Source: Studies from the "PubMed", "Embase", and "BVS" databases were analyzed. Studies Selection: The articles selected in the review included: cohort and case-control studies that addressed the proposed theme, published between January 1, 2017, and January 31, 2022, in English, Portuguese, and Spanish. As inclusion criteria: cohort and case-control articles. As exclusion criteria: articles outside the scope of the research, review articles, case reports, articles using animal models, abstracts, letters to the editor, and articles found duplicates in the databases. Data Collection: Number of couples or cycles; age (men/ women); collection type; DNA damage (%); assisted reproduction activity and techniques. Data Synthesis: In in vitro fertilization, a reduction in fertilization rate, blastocyst rate, and embryo quality was observed. In addition to implantation and increased abortion rates in patients with high sperm DNA fragmentation. High rates of sperm DNA fragmentation in intracytoplasmic sperm injection led to reduced blastocyst production rate, embryo quality, implantation, and live birth rate, and in intrauterine insemination, a reduction in pregnancy rate. Conclusion: Sperm DNA fragmentation was a potential limiting factor for assisted reproduction techniques.

Does microfluidic sperm selection improve clinical pregnancy and miscarriage outcomes in assisted reproductive treatments? A systematic review and meta-analysis

“…Interestingly, when swim-up was the control method, the rates appeared more favorable for this group. This observation aligns with the notion that techniques preserving the acrosomal cap might cause less DNA damage to sperm [54,55], though this premise remains debated [56].…”

“…For total blastocyst formation (Fig 4C ) and the derivation of good/excellent quality blastocysts (Fig 4D ), the data leaned in favor of MFSS usage. Though not achieving statistical significance, these findings buttress the argument for enhanced outcomes when spermatozoa avoid rigorous procedures during ICSI selection [54].…”

Unraveling the Impact of Sperm DNA Fragmentation on Reproductive Outcomes

“…All studies showed that DNA fragmentation had a negative impact on embryo quality and development in IVF as well as ICSI cycles. 70 In agreement with these results, a recent retrospective study involving 176 couples with unexplained infertility undergoing IVF or ICSI showed that SDF levels >25% were significantly correlated with a decrease in the number of day 3 good-quality embryos ( r = −0.347, p < 0.001). 71 In contrast to these findings, previous systematic reviews that gathered evidence from numerous sources did not establish a clear association.…”

Management of Primary Infertility: A Comprehensive Approach With Magnetic-Activated Cell Sorting in an Asthenozoospermic Patient

“…The technique used in laboratories that are considered the gold standard for attempting to diagnose male infertility is semen analysis. It evaluates the factors of infertility such as morphology, sperm motility, liquefaction time, seminal volume, sperm concentration, and sperm [ 5 ]. ART has been widely included in the management of infertile couples.…”