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Correlation of sperm DNA damage with IVF and ICSI outcomes: a systematic review and meta-analysis

Zhongxiang Li1, Liquan Wang, Jie Cai

  • 1Center for Reproductive Medicine, Women' Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310006, PR China.

Journal of Assisted Reproduction and Genetics
|October 5, 2006
PubMed
Abstract

Insights

Sperm DNA damage significantly reduces IVF clinical pregnancy rates when measured by the TUNEL assay, but not fertilization rates or ICSI outcomes. The SCSA assay showed no significant impact on pregnancy rates for either IVF or ICSI.

Area of Science:

  • Reproductive Medicine
  • Genetics
  • Infertility Research

Background:

  • Sperm DNA damage is a potential factor affecting male fertility and assisted reproductive technology (ART) outcomes.
  • Two common assays, the TUNEL assay and Sperm Chromatin Structure Assay (SCSA), are used to evaluate sperm DNA integrity.

Purpose of the Study:

  • To systematically evaluate the impact of sperm DNA damage, assessed by TUNEL and SCSA, on in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment success rates.
  • To synthesize existing evidence through meta-analysis to clarify the clinical significance of sperm DNA damage in ART.

Main Methods:

  • A comprehensive literature search of Medline and bibliographies was conducted for studies published between January 1978 and April 2006.
  • Eight eligible studies were included in separate meta-analyses: five using the TUNEL assay and three using the SCSA.
  • Meta-analyses were performed using RevMan software, employing fixed-effect or random-effects models as appropriate.

Main Results:

  • For the TUNEL assay, high sperm DNA damage significantly decreased IVF clinical pregnancy rates (RR 0.68, P = 0.006) but not fertilization rates (RR 0.79, P = 0.23).
  • ICSI outcomes showed no significant difference in fertilization (RR 1.03, P = 0.70) or clinical pregnancy rates (RR 0.76, P = 0.09) based on sperm DNA damage levels.
  • The SCSA assay revealed no significant effect of sperm DNA damage on clinical pregnancy rates for either IVF (RR 0.58, P = 0.19) or ICSI (RR 1.18, P = 0.38).

Conclusions:

  • Sperm DNA damage, when assessed by the TUNEL assay, negatively impacts IVF clinical pregnancy rates, but not fertilization rates or ICSI outcomes.
  • Sperm DNA damage, as measured by the SCSA, does not demonstrate a significant association with clinical pregnancy rates following IVF or ICSI treatment.
  • The choice of assay may influence the interpretation of sperm DNA damage's effect on ART success.

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