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Personalized prediction model for miscarriage: in-depth sperm DNA fragmentation
Chun-I Lee1,2,3, Tse-En Wang1, Chien-Hong Chen1,4
1Division of Infertility Clinic, Taiwan, IVF Centers Lee Women'S Hospital, Taichung, Taiwan.
Journal of Assisted Reproduction and Genetics
|March 25, 2025
Summary
Sperm DNA fragmentation, particularly double-strand breaks (DSBs), significantly impacts miscarriage risk in couples with poor ICSI prognosis. DSB testing can refine pre-treatment evaluation for these patients.
Area of Science:
- Reproductive Medicine
- Genetics
- Infertility Research
Background:
- Intracytoplasmic sperm injection (ICSI) is a key assisted reproductive technology.
- Sperm DNA fragmentation (SDF) and female reproductive potential are critical factors in ICSI success.
- The POSEIDON criteria stratify patients undergoing ICSI into normal and poor prognosis groups.
Purpose of the Study:
- To investigate the combined impact of different sperm DNA fragmentation (SDF) types and female reproductive potential on ICSI outcomes.
- To identify specific risk factors contributing to ICSI failures in both normal and poor prognosis groups.
Main Methods:
- Retrospective analysis of 195 couples undergoing ICSI, categorized by POSEIDON criteria.
- Assessment of female factors (age, AMH, oocyte retrieval) and male factors (semen parameters, total SDF, double-strand breaks - DSBs).
- Logistic regression and ROC curve analysis to identify and assess the predictive power of risk factors for reproductive outcomes.
Main Results:
- In normal prognosis, female factors like AMH and oocyte number were linked to failures.
- In poor prognosis, male factors including reduced sperm motility, poor morphology, and elevated DSBs were associated with miscarriage.
- Elevated DSBs independently predicted miscarriage risk (OR: 1.19), with a 19% cutoff showing 81% accuracy.
Conclusions:
- Paternal factors, especially elevated DSBs, significantly increase miscarriage risk in women with poor ICSI prognosis.
- DSB testing is proposed as an initial evaluation step for infertile couples, particularly those with poor prognosis, before assisted reproductive treatments.
