In a nutshell
This study investigated if female age and sperm DNA fragmentation (SDF) affects fertility outcomes.
They found that increasing female age and high SDF negatively affected fertility outcomes.
Some background
Assisted reproductive technologies (ARTs) are used to treat infertility. In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are ARTs. Understanding the cause of infertility is important. It can be useful in determining the best treatment option. The knowledge of fertility is continually increasing. One of the more recent findings is sperm DNA fragmentation (SDF). When DNA breaks it can lead to poor quality sperm. SDF can affect sperm survival and other factors. This can lead to impaired fertility.
Male infertility is not necessarily the only issue. Reduced female fertility may also affect fertility outcomes. Increasing female age is associated with reduced fertility. Few studies have investigated the combined effect of female age and SDF on fertility outcomes in couples undergoing IVF/ICSI.
Methods & findings
This study included 2,371 couples undergoing IVF/ICSI. SDF was measured in men using the DNA fragmentation index (DFI). DFI was categorized as more than 30% SDF (DFI-high) and 30% or less SDF (DFI-normal). Female age was divided into women below 30 years (FA30-) or 30 and above (FA30+). Fertility outcomes measured included the clinical pregnancy rate (CPR).
Semen quality was poorer in men that were DFI-high. In couples with DFI-high, female age was related to CPR. Increasing female age was associated with reduced CPR when DFI was high. This means that FA30+ had an added effect on fertility outcomes when combined with high DFI. In women below 30, the effect of DFI on fertility outcomes was not statistically significant. High DFI and FA35+ were associated with more spontaneous abortions.
The bottom line
The authors concluded that increasing female age and high SDF combined negatively affected fertility outcomes.
The fine print
DFI was measured 1-2 months before IVF/ICSI. This could have changed immediately before the IVF/ICSI procedure. It is unclear if the ART choice should depend on the female age and SDF. More studies are needed.
What’s next?
If you have any concerns regarding infertility management please consult with your doctor.
Published By :
Reproductive BioMedicine Online
Date :
Dec 01, 2019
