title: Value of the sperm deoxyribonucleic acid fragmentation level, as measured by the sperm chromatin dispersion test, in the outcome of in vitro fertilization and intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To determine the prognostic value of sperm DNA fragmentation levels, as measured by the sperm chromatin dispersion (SCD) test, in predicting IVF and ICSI outcome.
  
  
  METHODS
  Double-blind prospective study.
  
  
  METHODS
  University-affiliated private IVF setting.
  
  
  METHODS
  A total of 85 couples undergoing infertility treatment with IVF/ICSI.
  
  
  METHODS
  Analysis of DNA fragmentation by the SCD test in 170 aliquots obtained from the ejaculate and from the processed semen used for assisted reproductive technologies (ART).
  
  
  METHODS
  Percentage of spermatozoa with fragmented DNA was statistically correlated with embryo quality and reproductive success.
  
  
  RESULTS
  Fertilization rate was inversely correlated with DNA fragmentation (r = -0.245 P = .045). Higher DNA fragmentation rate gave an increased proportion of zygotes showing asynchrony between the nucleolar precursor bodies of zygote pronuclei (73.8% vs. 28.8% P < .001). In addition, the slower embryo development and worst morphology on day 6 was correlated with higher sperm DNA fragmentation (47.7% vs. 29.4% P = .044). We also observed a negative correlation between DNA fragmentation and the implantation rate (r = -0.250 P = .042). However, SCD test values were not statistically different in cycles that resulted in a pregnancy compared with those that did not (33.2 vs. 28.2 and 32.4 vs. 34.7).
  
  
  CONCLUSIONS
  This is the first report that describes a correlation between sperm DNA integrity, as measured by the SCD test, and fertilization rate, embryo quality, and implantation rate in IVF/ICSI. The degree of DNA fragmentation was inversely correlated with fertilization rate, synchrony of the nucleolar precursor bodies' pattern in pronuclei, embryo ability to achieve blastocyst stage, and embryo morphological quality. Because SCD test values were correlated with embryo quality and blastocyst rate, the lack of correlation between sperm DNA fragmentation and pregnancy outcome in IVF might be due to embryo selection before transfer. The ability of the SCD test to predict the blastocyst rate after IVF/ICSI warrants further study.
authors.affiliation: Sección de Genetica, Hospital Teresa Herrera, Complejo Hospitalario Universitario Juan Canalejo, A Coruña, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Muriel
authors.forename: Nicolás
authors.initials: N
authors.lastname: Garrido
authors.forename: José Luis
authors.initials: JL
authors.lastname: Fernández
authors.forename: José
authors.initials: J
authors.lastname: Remohí
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellicer
authors.forename: Maria José
authors.initials: MJ
authors.lastname: de los Santos
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000502:physiology; D002466:Cell Nucleolus / Q000648:ultrastructure; D002843:Chromatin / Q000378:metabolism*; D053938:DNA Fragmentation; D010064:Embryo Implantation; D047108:Embryonic Development; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000378:metabolism*; D016896:Treatment Outcome; D015053:Zygote / Q000648:ultrastructure
chemical_list: D002843:Chromatin