Influence of the level of sperm DNA fragmentation on outcomes ART programs
DOI:
https://doi.org/10.37800/RM.2.2024.21-28Keywords:
Assisted Reproductive Technologies (ART), in vitro fertilization (IVF), DNA fragmentationAbstract
Relevance: Experts in the field of assisted reproductive technologies (ART) agree that to increase the number of successful ART programs, it is necessary to identify evidence-based predictors of adverse outcomes. The literature data on the effect of the level of DNA fragmentation of spermatozoa on the outcomes of ART programs are quite contradictory.
The study aimed to analyze current data on the effect of the level of DNA fragmentation of sperm on the outcomes of assisted reproductive technology programs.
Materials and methods: The review encompasses a comprehensive search of published data over the past 7 years on the effectiveness of ART programs and pregnancy outcomes, meticulously considering the level of DNA fragmentation of sperm. The literature was exhaustively searched in the databases Medline, Scopus, Web of Science, Google Scholar, PubMed, Wiley and Cochrane Library.
Results: According to most authors, there is no apparent relationship between the level of fragmentation of sperm DNA and the frequency of clinical pregnancy; however, there is an undeniable correlation between the percentage of fragmentation and habitual miscarriage. The technology of intracytoplasmic sperm injection (ICSI) has an obvious advantage as a method of choosing assisted reproduction with high DNA fragmentation since there is no decrease in the live birth rate. The technique of aspiration sperm biopsy (TESA) significantly increases the clinical incidence of pregnancy and live births in married couples with a high level of DNA fragmentation of spermatozoa in ICSI.
Conclusion: The literature data on the topic under study are pretty contradictory. DNA fragmentation of spermatozoa is a valuable method for assessing male fertility. Still, its importance as a predictor of pregnancy outcomes after the use of assisted reproductive technologies requires further study.
References
Banks N, Sun F, Krawetz SA, Coward RM, Masson P, Smith JF, Trussell JC, Santoro N, Zhang H, Steiner AZ. Male vitamin D status and male factor infertility. Fertil Steril. 2021;116(4):973-979.
https://doi.org/10.1016/j.fertnstert.2021.06.035
Turner KA, Rambhatla A, Schon S, Agarwal A, Krawetz SA, Dupree JM, Avidor-Reiss T. Male Infertility is a Women's Health Issue – Research and Clinical Evaluation of Male Infertility Is Needed. Cells. 2020;9(4):990.
https://doi.org/10.3390/cells9040990
Dong C, Wang Z, Shen P, Chen Y, Wang J, Wang H. Epigallocatechin-3-gallate suppresses the growth of human osteosarcoma by inhibiting the Wnt/β-catenin signaling pathway. Bioengineered. 2022;13(4):8490-8502.
https://doi.org/10.1080/21655979.2022.2051805
Malić Vončina S, Stenqvist A, Bungum M, Schyman T, Giwercman A. Sperm DNA fragmentation index and cumulative live birth rate in a cohort of 2,713 couples undergoing assisted reproduction treatment. Fertil Steril. 2021;116(6):1483-1490.
https://doi.org/10.1016/j.fertnstert.2021.06.049
ESHRE Working group on Time-lapse technology; Apter S, Ebner T, Freour T, Guns Y, Kovacic B, Le Clef N, Marques M, Meseguer M, Montjean D, Sfontouris I, Sturmey R, Coticchio G. Good practice recommendations for the use of time-lapse technology. Hum Reprod Open. 2020;2:8.
https://doi.org/10.1093/hropen/hoaa008
Hervás I, Pacheco A, Rivera-Egea R, Gil Julia M, Navarro-Gomezlechon A, Garrido N. IVF/ICSI cumulative live birth rates per consumed oocyte remain comparable regardless of sperm DNA fragmentation by TUNEL. Reprod Biomed Online. 2022;44(6):1079-1089.
https://doi.org/10.1016/j.rbmo.2022.02.010
Wang Q, Gu X, Chen Y, Yu M, Peng L, Zhong S, Wang X, Lv J. The effect of sperm DNA fragmentation on in vitro fertilization outcomes unexplained infertility. Clinics (Sao Paulo). 2023;78:100261.
https://doi.org/10.1016/j.clinsp.2023.100261
Wang QX, Wang X, Yu MY, Sun H, Wang D, Zhong SP, Guo F. Random sperm DNA fragmentation index is not associated with clinical outcomes in day-3 frozen embryo transfer. Asian J Androl. 2022;24(1):109-115.
https://doi.org/10.4103/aja.aja_17_21
Setti AS, Braga DPAF, Guilherme P, Provenza R, Iaconelli A, Borges E. Morphokinetic parameter comparison between embryos from couples with high or low sperm DNA fragmentation index. FS Sci. 2021;2(4):345-354.
https://doi.org/10.1016/j.xfss.2021.10.001
Kim DS, Song SH. Effect of Sperm DNA Fragmentation on Embryo Quality in Normal Responder Women in IVF and ICSI. Yonsei Med J. 2020;61(11):986-987.
https://doi.org/10.3349/ymj.2020.61.11.986
Anbari F, Khalili MA, Agha-Rahimi A, Maleki B, Nabi A, Esfandiari N. Does sperm DNA fragmentation have a negative impact on embryo morphology and morphokinetics in IVF programme? Andrologia. 2020;52(11):e13798.
https://doi.org/10.1111/and.13798
Broussard AL, Leader B, Tirado E, Russell H, Beydoun H, Colver R, Reuter L, Bopp B, Will M, Anspach Will E, Adaniya G. Sperm deoxyribonucleic acid fragmentation index at the time of intracytoplasmic sperm injection and standard in vitro fertilization is correlated with lower fertilization but not with blastocyst genetic diagnosis. FS Rep. 2023;4(2):183-189.
https://doi.org/10.1016/j.xfre.2023.04.006
Alharbi M, Hamouche F, Phillips S, Kadoch JI, Zini A. Use of testicular sperm in couples with SCSA-defined high sperm DNA fragmentation and failed intracytoplasmic sperm injection using ejaculated sperm. Asian J. Androl. 2020;22(4):348-353.
https://doi.org/10.4103/aja.aja_99_19
Douglas C, Parekh N, Kahn LG, Henkel R, Agarwal A. A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men. World J Mens’ Health. 2021;39(2):172-185.
https://doi.org/10.5534/wjmh.190088
Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SEM., Sharma R, Humaidan P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia. 2021;53(2):e13874.
https://doi.org/10.1111/and.13874
Lourenço ML, Moura GA, Rocha YM, Rodrigues JPV, Monteiro PB. Impact of sperm DNA fragmentation on the clinical outcome of assisted reproduction techniques: a systematic review of the last five years. JBRA Assist Reprod. 2023;7(2):282-291.
https://doi.org/10.5935/1518-0557.20220057
Li H, Deng H, Zhao J, Zhong YC, Zhu L, Wu YQ, Ma WM. Impact of sperm DNA fragmentation on the outcome of frozen-thawed blastocyst transfer in in vitro fertilization and embryo transfer. Zhonghua Nan Ke Xue. Natl J Androl. 2020;26(5):422-426. (in Chi.).
https://europepmc.org/article/med/33354950
Ten J, Guerrero J, Linares Á, Rodríguez-Arnedo A, Morales R, Lledó B, Llácer J, Bernabeu R. Sperm DNA fragmentation on the day of fertilization is not associated with assisted reproductive technique outcome independently of gamete quality. Hum Fertil (Camb.). 2022;25(4):706-715.
https://doi.org/10.1080/14647273.2021.1877364
Antonouli S, Papatheodorou A, Panagiotidis Y, Petousis S, Prapas N, Nottola S.A, Palmerini MG, Macchiarelli G, Prapas Y. The impact of sperm DNA fragmentation on ICSI outcome in cases of donated oocytes. Arch Gynecol Obstet. 2019;300(1):207-215.
https://doi.org/10.1007/s00404-019-05133-9
Chen Y, Li W, Chen X. The Association of Sperm DNA Fragment and Assisted Reproductive Outcomes: A Meta-Analysis. Comput Math Methods Med. 2022;11:26616.
https://doi.org/10.1155/2022/1126616
Çağlayan A, Horsanali MO, Buyrukcu BA. The role of sperm DNA integrity in couples with recurrent implantation failure following IVF treatment. Andrologia. 2022;54(9):e14496.
https://doi.org/10.1111/and.14496
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(1):2717.
https://doi.org/10.1038/s41598-023-28765-z
Karavani G, Kan-Tor Y, Schachter-Safrai N, Levitas E, Or Y, Ben-Meir A, Buxboim A, Har-Vardi I. Does sperm origin-Ejaculated or testicular affect embryo morpho-kinetic parameters? Andrology. 2021;9(2):632-639.
https://doi.org/10.1111/andr.12952
Moreno-Sepulveda J, Rajmil O. Seminal human papillomavirus infection and reproduction: a systematic review and meta-analysis. Andrology. 2021;9(2):478-502.
https://doi.org/10.1111/andr.12948
Рогозин Д.С. Мужская фертильность: обзор литературы января-марта 2021 года. Вестник урологии. 2021;9(2):142-149.
Rogozin DS. Male fertility: literature review for January-March 2021. Vestnik urologii. 2021;9(2):142-149. (in Russ.).
https://doi.org/10.21886/2308-6424-2021-9-2-142-149
Romano M, Cirillo F, Spadaro D, Busnelli A, Castellano S, Albani E, Levi-Setti PE. High sperm DNA fragmentation: do we have robust evidence to support antioxidants and testicular sperm extraction to improve fertility outcomes? A narrative review. Front. Endocrinol. 2023;14:1150951.
https://doi.org/10.3389/fendo.2023.1150951
Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho CL, Henkel R, Finelli R, Leisegang K, Sengupta P, Barbarosie C, Parekh N, Alves MG, Ko E, Arafa M, Tadros N, Ramasamy R, Kavoussi P, Ambar R, Kuchakulla M, Robert KA, Iovine C, Durairajanayagam D, Jindal S, Shah R. Sperm DNA Fragmentation: A New Guideline for Clinicians. World J Mens’ Health. 2020;38(4):412-471.
https://doi.org/10.5534/wjmh.200128
Arafa M, AlMalki A, AlBadr M, Burjaq H, Majzoub A, AlSaid S, Elbardisi H. ICSI outcome in patients with high DNA fragmentation: Testicular versus ejaculated spermatozoa. Andrologia. 2018;50(1):e12835.
https://doi.org/10.1111/and.12835
Dai Y, Liu J, Yuan E, Li Y, Shi Y, Zhang L. Relationship Among Traditional Semen Parameters, Sperm DNA Fragmentation, and Unexplained Recurrent Miscarriage: A Systematic Review and Meta-Analysis. Front Endocrinol. 2022;12:802632.
https://doi.org/10.3389/fendo.2021.802632
Haddock L, Gordon S, Lewis SEM, Larsen P, Shehata A, Shehata H. Sperm DNA fragmentation is a novel biomarker for early pregnancy loss. Reprod Biomed Online. 2021;42(1):175-184.
https://doi.org/10.1016/j.rbmo.2020.09.016
Zhang H, Li Y, Wang H, Zhou W, Zheng Y, Ye D. Does sperm DNA fragmentation affect clinical outcomes during vitrified-warmed single-blastocyst transfer cycles? A retrospective analysis of 2034 vitrified-warmed single-blastocyst transfer cycles. J Assist Reprod Genet. 2022;39(6):1359-1366.
https://doi.org/10.1007/s10815-022-02484-2
Green KA, Patounakis G, Dougherty MP, Werner MD, Scott RT, Franasiak JM. Sperm DNA fragmentation on the day of fertilization is not associated with embryologic or clinical outcomes after IVF/ICSI. J Assist Reprod Genet. 2020;37(1):71-76.
https://doi.org/10.1007/s10815-019-01632-5
McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2019;112(1):54-60.e3.
https://doi.org/10.1016/j.fertnstert.2019.03.003
Рогозин Д.С. Мужская фертильность: обзор публикаций октября-декабря 2021 года. Вестник урологии. 2022;10(1):135-146. Rogozin DS. Male fertility: literature review for October-December 2021. Vestnik urologii. 2022;10(1):135-146. (in Russ.).
https://doi.org/10.21886/2308-6424-2022-10-1-135-146
Khalafalla K, Majzoub A, Elbardisi H, Bhathella A, Chaudhari A, Agarwal A, Henkel R, Al-Marzooki T, Burjaq H, Arafa M. The effect of sperm DNA fragmentation on intracytoplasmic sperm injection outcome. Andrologia. 2021;53(10):e14180.
https://doi.org/10.1111/and.14180
Chen Q, Zhao JY, Xue X, Zhu GX. The association between sperm DNA fragmentation and reproductive outcomes following intrauterine insemination, a meta-analysis. Reprod Toxicol. 2019;8:50-55.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 The rights to a manuscript accepted for publication are transferred to the Journal Publisher. When reprinting all or part of the material, the author must refer to the primary publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The articles published in this Journal are licensed under the CC BY-NC-ND 4.0 (Creative Commons Attribution – Non-Commercial – No Derivatives 4.0 International) license, which provides for their non-commercial use only. Under this license, users have the right to copy and distribute the material in copyright but are not permitted to modify or use it for commercial purposes. Full details on the licensing are available at https://creativecommons.org/licenses/by-nc-nd/4.0/.
