title: Sperm chromatin structure assay parameters measured after density gradient centrifugation are not predictive for the outcome of ART.
abstract: BACKGROUND
  The sperm chromatin structure assay (SCSA) parameter DNA fragmentation index (DFI) has been shown to predict in vivo and in vitro fertility. So far most SCSA studies have been based on SCSA analysis performed on neat semen. The aim of this study is to assess whether SCSA analysis of sperm prepared by density gradient centrifugation (DGC) could add more information in regard to the prediction of treatment outcome.
  
  
  METHODS
  The study included 510 assisted reproductive technique (ART) cycles. SCSA was performed in neat semen and post DGC. SCSA results were expressed in terms of DFI and high DNA stainability (HDS) cell fractions. The outcome parameter was clinical pregnancy (CP).
  
  
  RESULTS
  Scatter-plot diagrams demonstrated that for DGC samples, no DFI cut-off values could be set for in vivo or in vitro fertility. In intrauterine insemination, IVF and ICSI groups the mean difference (95% CI) in DFI post DGC between those who achieved CP and those who did not was 0.2% (-1.7 to 2.0%), 0.4% (-1.9 to 2.8%) and 1.3% (-3.1 to 5.9%), respectively, none of these being statistically significant. The corresponding differences for HDS were 0.1% (-1.3 to 1.5%), 0.1% (-0.7 to 0.9%) and 0.6% (-1.6 to 2.7%), respectively (all P-values >0.6).
  
  
  CONCLUSIONS
  SCSA performed in semen prepared by DGC cannot predict the outcome of ART.
authors.affiliation: Centre of Reproductive Medicine, Malmö University Hospital, 205 02 Malmö, Sweden. mona.bungum@med.lu.se
authors.forename: Mona
authors.initials: M
authors.lastname: Bungum
authors.forename: Marcello
authors.initials: M
authors.lastname: Spanò
authors.forename: Peter
authors.initials: P
authors.lastname: Humaidan
authors.forename: Patrizia
authors.initials: P
authors.lastname: Eleuteri
authors.forename: Michele
authors.initials: M
authors.lastname: Rescia
authors.forename: Aleksander
authors.initials: A
authors.lastname: Giwercman
mesh_terms: D000328:Adult; D002499:Centrifugation, Density Gradient; D002843:Chromatin / Q000235:genetics*; D015331:Cohort Studies; D004247:DNA / Q000378:metabolism; D053938:DNA Fragmentation; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000378:metabolism*; D013194:Staining and Labeling; D016896:Treatment Outcome
chemical_list: D002843:Chromatin; D004247:DNA