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

Lin, Ming-Huei; Lee, Robert Kuo-Kuang; Li, Sheng-Hsiang; Lu, Chih-Wei; Sun, Fang‐Ju; Hwu, Yuh‐Ming

doi:10.1016/j.fertnstert.2007.06.018

Cited by 254 publications

(192 citation statements)

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“…However, if the type and extent of DNA damage can be balanced by the reparative ability of the oocyte, it is possible to achieve fertilization even in the presence of elevated sperm DNA fragmentation rates [10,40,41]. Additionally, in ICSI, the natural selection barriers are bypassed entirely and fertilization with highly DNA-fragmented sperm is possible.…”

Section: Discussionmentioning

confidence: 99%

High Pregnancy and Implantation Rates Can Be Obtained Using Magnetic-Activated Cell Sorting (MACS) to Selection Spermatozoa in Patients with High Levels of Spermatic DNA Fragmentation

Ferreyra¹

2014

JFIV Reprod Med Genet

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Purpose: DNA fragmentation in spermatozoa has been associated with poor semen quality, low fertilization rates, impaired preimplantation development, and high miscarriage rates. The objective of this study was to evaluate the effects of the use of non-apoptotic MACS-selected spermatozoa in ICSI cycles, compared to those ICSI cycles in patients with normal sperm DNA fragmentation.Methods: A total of 134 cycles of ICSI were included in the study. The study group consisted of patients with high DNA fragmentation and their spermatozoa were selected by MACS (n=57); and the control group, of patients with normal DNA fragmentation and their spermatozoa were selected by classic morphological characteristics. The fertilization rate, cleavage rate, embryo quality, pregnancy rate (PR), implantation rate (IR) and miscarriage rate (MR) were compared between groups.Results: There was no difference in the fertilization rate (74.5 and 76.5%), cleavage rate and good embryo quality at Day 3 (98.3 and 89.1%; 88.4 and 83.7%) or blastocyst formation rate (50.8 and 41.1%) for the study and control groups, respectively. PRs, IRs and MRs were similar for the study group compared to the control group (PR: 63.2 versus 45.5%; IR: 37.4 versus 28.1%; MR: 8.3 versus 17.1). The women were distributed into three groups: <35 years, 35-39 years and ≥ 40 years. Pregnancy, implantation and miscarriage rates were similar in the three evaluated groups (P: NS). Conclusions:By selecting non-apoptotic sperm by MACS, we can achieve very acceptable pregnancy and implantation rates; being a good option for couples with high sperm DNA fragmentation and repeated assisted reproduction failures. Citation: García-Ferreyra J, Villegas L, Romero R, Zavala P, Hilario R, et al. (2014) High Pregnancy and Implantation Rates Can Be Obtained Using Magnetic-Activated Cell Sorting (MACS) to Selection Spermatozoa in Patients with High Levels of Spermatic DNA Fragmentation. JFIV Reprod Med Genet 3: 133. doi:10.4172/2375-4508.1000133 Several studies reported an improvement in fertilization rates [15,16] and embryo quality [17][18][19] because the best sperms were selected using MACS compared to standard selection methods. On the other hand, Gil et al. [20] showed that the implantation and miscarriage rated did not vary between MACS or standard sperm selection methods; however, they did observe an improvement in pregnancy rates. High Pregnancy and Implantation Rates CanIn this study, we evaluated the effects of using MACS as a sperm selection technique in patients with high DNA fragmentation compared with patients with normal DNA fragmentation and determine the efficacy of such technique in the hopes of improving ART success rates. Materials and Methods PatientsIn this study, we analyzed 134 cycles of ICSI that were done between March 2012 and April 2014 at FERTILAB Laboratory of Assisted Reproduction (Lima, Peru), all approved by the Institutional Review Board (IRB) and the corresponding Ethics Committee. Written consent was obtained from all patients and their...

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Section: Discussionmentioning

confidence: 99%

High Pregnancy and Implantation Rates Can Be Obtained Using Magnetic-Activated Cell Sorting (MACS) to Selection Spermatozoa in Patients with High Levels of Spermatic DNA Fragmentation

Ferreyra¹

2014

JFIV Reprod Med Genet

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“…With this constraint, a systematic review and meta-analysis of the eleven IVF studies that can be evaluated by a 2 × 2 table shows that sperm DNA damage is associated with lower IVF pregnancy rates. The combined OR is 1.70 (95% CI 1.30, 2.23, p < 0.05) [Benchaib et al 2007;Boe-Hansen et al 2006;Borini et al 2006;Bungum et al 2007;Filatov et al 1999;Frydman et al 2008;Henkel et al 2003;Host et al 2000;Huang et al 2005;Lin et al 2008;Tarozzi et al 2009]. The characteristics of these 11 IVF studies included in the analysis are shown in Tables 2 and 3.…”

Section: Relationship Between Sperm Dna Damage and Pregnancymentioning

confidence: 99%

Are sperm chromatin and DNA defects relevant in the clinic?

Zini

2011

Systems Biology in Reproductive Medicine

228

196

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There has been an increase in the use of sperm DNA and chromatin integrity tests in the evaluation of the infertile man with the hypothesis that these tests may better diagnose infertility and predict reproductive outcomes. This review discusses the etiology of sperm DNA damage, briefly describing the tests of sperm DNA damage, and evaluates the relationship between sperm DNA damage and reproductive outcomes. A systematic review of the literature allows us to conclude that sperm DNA damage is associated with lower natural, intra-uterine insemination (IUI), and in vitro fertilization (IVF) pregnancy rates. Studies to date have not shown a clear association between sperm DNA and chromatin defects and pregnancy outcomes after intra-cytoplasmic sperm injection (ICSI). However, we cannot exclude the possibility that very high levels of DNA damage will impact on ICSI outcomes. In couples undergoing IVF or ICSI, there is evidence to show that sperm DNA damage is associated with an increased risk of pregnancy loss. A limitation of this systematic review and meta-analysis is that it does not address the heterogeneity of the individual study characteristics. Although the clinical utility of tests of sperm DNA damage remains to be firmly established, the data suggest that there is clinical value in testing couples prior to assisted reproductive technologies (ARTs IUI, IVF, and ICSI) and in those couples with recurrent miscarriages. Additional, well-designed prospective studies are needed before testing becomes a routine part of patient care.

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“…54 Despite this, attempts have been made to correlate the quality of sperm decondensation with routine semen parameters, DNA integrity, and IVF fertilization rates, but no consistent relationship has been observed. 55 Thus, the role of diagnostic sperm nuclear decondensation in the male infertility evaluation is currently speculative.…”

Section: Chromatin Condensation and Sperm Epigeneticsmentioning

confidence: 99%

An Assessment of New Sperm Tests for Male Infertility

Natali

Turek

2011

Urology

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The routine semen analysis, although used for more than 50 years, fails to accurately distinguish between fertile and infertile men. As a consequence, many tests of sperm function (TSF) have been developed. This review discusses both older and newer diagnostic TSF. It outlines the principles underlying each assay and reviews aggregate clinical data to determine its current relevance and utility. It concludes that the relevance of many older TSF is questionable, with the wide acceptance of intracytoplasmic sperm injection (ICSI). Newer TSF have the potential to deliver more clinically relevant information but require more extensive study to better understand their predictive role in the ICSI era. UROLOGY 77: 1027-1034, 2011. © 2011 Elsevier Inc. All rights reserved.I n addition to the medical history and physical examination, the conventional semen analysis has been an essential laboratory test for the evaluation of male fertility for at least 50 years. However, the idea that fertility can be defined by threshold values of semen parameters is a concept that is fundamentally flawed. 1 Although not a true measure of fertility, the semen analysis, if abnormal, suggests that the probability of achieving fertility is lower than normal. 2 Because of biological variability, two semen analyses are generally needed, performed with two to three days of sexual abstinence and evaluated in a standardized fashion. 2 Recognized normal values for semen parameters are given in Table 1 in agreement with the latest recommendations by the World Health Organization (WHO). 2 Traditionally, (except for the latest WHO recommendations), these references are derived by expert consensus and not by prospective clinical trials and thus their true relationship to male fertility is unclear. In addition, the definition of what constitutes "normal" semen parameters is constantly challenged. A meta-analysis of 29 US studies of semen quality from 9612 fertile, or presumably fertile, men suggested that a sperm concentration of 98 million/mL is normal. 3 Although sperm motility is considered the "best" predictor of fertility, normal sperm motility ranges from 53% to 62%. 4 Thus, simply deriving "normal" semen parameters has been a prohibitively lengthy and inconclusive process to date.Finally, other biological variables affect the clinical utility of the semen analysis. In addition to wide intraindividual variation, seasonal 5 and geographic variation 4 further complicate the performance of the semen analysis as a fertility measure. As examples, within-subject, interejaculate coefficients of variation for sperm concentration and motility are estimated at 44.7% and 15% in one study. 1 Thus, even with excellent quality control, wide biological variation in semen quality profoundly challenges the notion that the conventional semen analysis can accurately assess male fertility. OLDER ADJUNCTIVE SPERM TESTSBecause of the need to more precisely characterize normal fertile semen, adjunctive semen testing has become popular (Figure 1). The concept behind de...

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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

Cited by 254 publications

References 59 publications

High Pregnancy and Implantation Rates Can Be Obtained Using Magnetic-Activated Cell Sorting (MACS) to Selection Spermatozoa in Patients with High Levels of Spermatic DNA Fragmentation

High Pregnancy and Implantation Rates Can Be Obtained Using Magnetic-Activated Cell Sorting (MACS) to Selection Spermatozoa in Patients with High Levels of Spermatic DNA Fragmentation

Are sperm chromatin and DNA defects relevant in the clinic?

An Assessment of New Sperm Tests for Male Infertility

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