In a nutshell
This article looks at sperm DNA fragmentation and if this influences assisted reproduction outcomes in women with different ovarian reserves.
Some background
Assisted reproduction techinques include in-vitro fertilization and intra-cytoplasmic sperm injection. In-vitro fertilization (IVF) is when a male sperm fertilizes the females’ egg in a laboratory dish outside the body. This is then implanted into the woman's uterus. Intra-cytoplasmic sperm injection (ICSI) involves a single sperm injected directly into an egg prior to IVF.
Sperm DNA fragmentation (SDF) is the level of damaged DNA found inside sperm. High levels of SDF are associated with lower levels of fertility.
It had previously been suggested that high levels of SDF may result in lower success rates when using IVF and ICSI.
Methods & findings
This study examined whether SDF affects the outcomes of IVF and ICSI, and whether it affects women with reduced ovarian reserve (the capacity of the ovary to provide egg cells that are capable of fertilization) differently than those with normal ovarian reserve.
2,865 couples were included in this study. It was the first IVF/ICSI cycle for each couple. The women were aged 20-46.
Women were classed as having a reduced ovarian reserve (ROR) if they had two of the following features: a high follicle stimulating hormone level (which can indicate reduced ovarian reserve), low number of follicles (egg cells) in the ovaries, or aged 38 years and above.
All other patients were classed as having a normal ovarian reserve (NOR).
Among the 2,865 cycles studied, the average age of women in the ROR group (36.1 years) was significantly higher than that in the NOR group (30.4 years).
The clinical pregnancy rate (CPR; when a fetal heartbeat is detected by ultrasound 4 weeks after embryo transfer) in the NOR group was 55.2%, and in the ROR group it was 22%.
SDF occuring in more than 27.3% of the DNA predicted decreased CPR and live birth rates in the ROR group. SDF over 27.3% was associated with an 84% decrease in the chance of a clinical pregnancy in the ROR group.
CPR and live birth rates were not affected in the NOR group. SDF over 27.3% significantly increased the risk of early abortion (before 20 weeks of pregnancy) in the NOR group (a 56% increase).
The bottom line
This study concluded that a high SDF level had a greater impact on pregnancy outcomes in couples with ROR.
The fine print
This study looked back at information already collected by researchers, sometimes this means that the data available isn’t as comprehensive as it should be.
Women received different fertility hormones depending on their ovarian reserve, this could have affected the outcomes.
What’s next?
Talk to your physician if you would like information on IVF/ICSI, or are concerned about sperm DNA fragmentation.
Published By :
Fertility and Sterility
Date :
Mar 04, 2015
