Do sperm DNA integrity tests predict pregnancy with in vitro fertilization?

Area of Science:

• Reproductive Medicine
• Andrology
• Infertility Diagnostics

Background:

• Sperm DNA integrity is crucial for successful conception.
• In vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are common infertility treatments.
• The predictive value of sperm DNA integrity tests in these treatments requires clarification.

Purpose of the Study:

• To systematically evaluate the predictive accuracy of sperm DNA integrity tests for pregnancy outcomes.
• To assess the diagnostic performance of these tests in couples undergoing IVF/ICSI.

Main Methods:

• A systematic review and meta-analysis of relevant studies.
• Included infertile couples undergoing IVF and ICSI.
• Analyzed diagnostic test properties of sperm DNA integrity tests performed before treatment cycles.

Main Results:

• 13 studies with 18 estimates were analyzed, involving 2162 treatment cycles.
• The summary diagnostic odds ratio was 1.44, but likelihood ratios were not predictive of pregnancy.
• Neither the sperm chromatin structure assay nor the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling assay showed superior predictive value.

Conclusions:

• A statistically significant but clinically weak association exists between sperm DNA integrity and IVF/ICSI pregnancy rates.
• Routine use of these tests for male infertility evaluation is not currently indicated.
• Further research may identify specific patient subgroups who could benefit from sperm DNA integrity testing.