title: Full-term pregnancies achieved with ICSI despite high levels of sperm chromatin damage.
abstract: BACKGROUND
  Sperm DNA integrity is essential for the accurate transmission of genetic information. The clinical significance of this assessment lies in its association with not only natural conception rates, but also the success of assisted reproduction technology (ART). It has been reported that sperm chromatin structure assay (SCSA) identified thresholds for negative pregnancy outcome after ART when the DNA fragmentation index (DFI), previously known as COMPalphat, was >30%.
  
  
  METHODS
  In a prospective clinical study, we examined 34 male infertile patients, the husbands of women undergoing conventional IVF or ICSI. SCSA and ART were carried out on semen aliquots taken from the same ejaculate. Fertilization rate, embryo quality and pregnancy rates were correlated to SCSA parameters, DFI and highly DNA stainable (HDS) cells.
  
  
  RESULTS
  No differences were seen in SCSA parameter values between patients initiating pregnancies and not doing so in either ICSI or conventional IVF. Pregnancies and normal delivery were obtained even with high levels of DFI.
  
  
  CONCLUSIONS
  There is still controversy over whether analytical techniques currently in use are able to identify the level of damage to spermatozoa. Large-scale studies should be conducted in different clinical settings to determine the effects of sperm DNA damage on the outcome of ART.
authors.affiliation: Department of Medical Pathophysiology, University of Rome, Rome, Italy. loredana.gandini@uniroma1.it
authors.forename: L
authors.initials: L
authors.lastname: Gandini
authors.forename: F
authors.initials: F
authors.lastname: Lombardo
authors.forename: D
authors.initials: D
authors.lastname: Paoli
authors.forename: F
authors.initials: F
authors.lastname: Caruso
authors.forename: P
authors.initials: P
authors.lastname: Eleuteri
authors.forename: G
authors.initials: G
authors.lastname: Leter
authors.forename: R
authors.initials: R
authors.lastname: Ciriminna
authors.forename: F
authors.initials: F
authors.lastname: Culasso
authors.forename: F
authors.initials: F
authors.lastname: Dondero
authors.forename: A
authors.initials: A
authors.lastname: Lenzi
authors.forename: M
authors.initials: M
authors.lastname: Spanò
mesh_terms: D000328:Adult; D002843:Chromatin / Q000235:genetics*; D053938:DNA Fragmentation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D011247:Pregnancy; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D002843:Chromatin