title: Effect of sperm DNA fragmentation on pregnancy outcome depends on oocyte quality.
abstract: OBJECTIVE
  To quantify the effect of sperm DNA fragmentation (SDF) on reproductive outcome by evaluating the most statistically significant bias factors using logistic regression.
  
  
  METHODS
  Prospective blind observational cohort study.
  
  
  METHODS
  University affiliated private IVF unit.
  
  
  METHODS
  Two hundred ten male partners of couples undergoing in vitro fertilization (IVF) or first intracytoplasmic sperm injection (ICSI) cycles with fresh or thawed sperm with the women's own or donated oocytes.
  
  
  METHODS
  None.
  
  
  METHODS
  SDF determined before and after swim-up (n=420), odds ratio calculated of the effect of an increase of one unit of SDF on pregnancy, and stratified regression analysis performed to evaluate the confusion effect of oocyte quality, sperm origin, and the fertilization procedure.
  
  
  RESULTS
  The effect of SDF on pregnancy was not affected by sperm origin (fresh or thawed) or fertilization procedure when measured both before and after swim-up. When oocytes from infertile patients were employed, SDF had a statistically significant negative impact on chance of pregnancy. For every 10% increase in SDF, the probability of not achieving pregnancy increased by 1.31. When donated oocytes were employed, SDF did not have a statistically significant effect.
  
  
  CONCLUSIONS
  The effect of SDF on the probability of pregnancy can be calculated independent of the fertilization procedure or sperm origin. Oocyte quality conditions the extent of the negative impact of SDF on pregnancy; this can be overcome when good quality oocytes are employed.
authors.affiliation: IVI, Universidad de Valencia, Valencia, Spain. marcos.meseguer@ivi.es
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
authors.forename: Rebeca
authors.initials: R
authors.lastname: Santiso
authors.forename: Nicolas
authors.initials: N
authors.lastname: Garrido
authors.forename: Sandra
authors.initials: S
authors.lastname: García-Herrero
authors.forename: Jose
authors.initials: J
authors.lastname: Remohí
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Fernandez
mesh_terms: D000328:Adult; D015925:Cryopreservation; D053938:DNA Fragmentation; D005260:Female; D005307:Fertilization in Vitro / Q000592:standards*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D009865:Oocytes / Q000166:cytology / Q000502:physiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D011446:Prospective Studies; D013094:Spermatozoa / Q000166:cytology / Q000502:physiology*