Sperm DNA fragmentation: paternal effect on early post-implantation embryo development in ART

Purpose Standard semen parameters are poor predictors of fertility potential. To date, apart from, paternal karyotyping sperm factors are not evaluated in recurrent pregnancy loss (RPL), only recent studies have emphasized the role of sperm factors in early embryonic development as sperm transcribes genes critical for early embryonic development. Sperm DNA integrity is useful diagnostic and prognostic marker and has clinical implications in idiopathic recurrent pregnancy loss (iRPL) following spontaneous conception. The aim of this study was to assess DNA integrity in cases experiencing iRPL following spontaneous conception. Methods Semen samples from 45 patients and 20 controls were analyzed as per WHO 1999 guidelines and sperm chromatin structure assay (SCSA) was used to measure DNA fragmentation index (DFI). Results By applying receiver operating curve (ROC) analysis, sperm DFI of approximately 26 % was found in male partner of couples experiencing iRPL. Conclusions Our data indicate that sperm from men with a history of iRPL have a higher percentage of DNA damage as compared to control group, and this can explain pregnancy loss in these patients. Men with higher DFI are infertile whereas men with lower DFI (26 %) are able to conceive but experience recurrent pregnancy loss. Thus it is important to evaluate sperm DFI in couples experiencing iRPL to understand exact aetiology of RPL and determine prognosis and management.

Section: Discussionmentioning

confidence: 91%

Predictive value of DNA integrity analysis in idiopathic recurrent pregnancy loss following spontaneous conception

Kumar

Deka

Singh

et al. 2012

“…As a result, the effects of injection of sperm with nuclear abnormalities are usually not detected before the 8-cell stage, when a high expression of genes derived from the sperm is initiated [4]. Studies suggest that this result reflects a late paternal effect, which is related to blockage of embryonic development observed during / after the implantation of embryos with normal karyotype [10,43].…”

Section: Introductionmentioning

confidence: 99%

The predictive value of high-magnification sperm morphology examination on ICSI outcomes in the presence of oocyte dysmorphisms

Setti

Braga

Figueira

et al. 2012

Purpose To evaluate the relationship between oocyte dysmorphisms and IMSI outcomes Methods Data of IMSI cycles performed in 332 patients were included in this study. Patients were included only if presented more than four and less than 30 oocytes upon oocyte retrieval. Patients who underwent IMSI were matched, concerning female age and sperm parameters, with patients who underwent ICSI in the same period (n0332). The two groups (ICSI and IMSI) were compared with regard to treatment outcomes. The influence of IMSI on fertilization and embryo quality on D3 and D5, when oocyte dysmorphisms were present was analyzed. Results A total of 6444 oocytes were morphologically evaluated and injected. Regardless of the oocyte quality, IMSI performance was a determinant of the increased odds of development to high quality embryo on D3 (OR: 1.98; CI: 1.54-2.56) and D5 (OR: 3.27; CI: 1.61-6.66). Conclusions The selection of a morphologically normal spermatozoon under high-magnification is associated with increased embryo quality, regardless of the oocyte morphology. The injection of a spermatozoon, selected under highmagnification, into a morphologically normal oocyte leads to the highest probability of developing high quality embryos.

“…Although not investigated in the current analysis, the recent literature on sperm DNA fragmentation have consistently demonstrated that the degree of fragmentation strongly correlates with spermatozoa parameters such as concentration, motility, and morphology with correlation coefficients as high as 0.50 [11][12][13][14][15]. Hence it is possible that the postprocessing spermatozoa motility may be an index of cryoinjury and DNA fragmentation [8].…”

Section: Discussionmentioning

confidence: 89%

“…Interestingly, this observation is highly consistent with findings from studies analyzing sperm DNA fragmentation and IVF outcomes. The majority of those studies demonstrated high sperm DNA fragmentation does not preclude fertilization but negatively impacts subsequent embryo development and reduces pregnancy rates [12,13,[15][16][17]. The initial steps of embryonic development from fertilization up to the 6-8 cell cleavage stage occur essentially independent of the embryonic/ paternal genome and are predominately under the influence of maternal transcripts packaged into the oocytes at the time of ovulation [18].…”

Section: Discussionmentioning

confidence: 99%

Optimization of IVF pregnancy outcomes with donor spermatozoa

Wang

Douglas

Prosser

et al. 2009

Purpose To identify risk factors for suboptimal IVF outcomes using insemination with donor spermatozoa and to define a lower threshold that may signal a conversion to fertilization by ICSI rather than insemination. Method Retrospective, age-matched, case-control study of women undergoing non-donor oocyte IVF cycles using either freshly ejaculated (N=138) or cryopreserved donor spermatozoa (N=69). Associations between method of fertilization, semen sample parameters, and pregnancy rates were analyzed. Results In vitro fertilization of oocytes with donor spermatozoa by insemination results in equivalent fertilization and pregnancy rates compared to those of freshly ejaculated spermatozoa from men with normal semen analyses when the post-processing motility is greater than or equal to 88%. IVF by insemination with donor spermatozoa when the post-processing motility is less than 88% is associated with a 5-fold reduction in pregnancy rates when compared to those of donor spermatozoa above this motility threshold. When the post-processing donor spermatozoa motility is low, fertilization by ICSI is associated with significantly higher pregnancy rates compared to those of insemination. Conclusion While ICSI does not need to be categorically instituted when using donor spermatozoa in IVF, patients should be counseled that conversion from insemination to ICSI may be recommended based on low post-processing motility.