title: Sperm DNA damage measured by the alkaline Comet assay as an independent predictor of male infertility and in vitro fertilization success.
abstract: OBJECTIVE
  To evaluate sperm DNA fragmentation and semen parameters to diagnose male factor infertility and predict pregnancy after IVF.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Academic research laboratory.
  
  
  METHODS
  Seventy-five couples undergoing IVF and 28 fertile donors.
  
  
  METHODS
  Sperm DNA fragmentation was measured by the alkaline Comet assay in semen and sperm after density gradient centrifugation (DGC). Binary logistic regression was used to analyze odds ratios (OR) and relative risks (RR) for IVF outcomes.
  
  
  METHODS
  Semen parameters and sperm DNA fragmentation in semen and DGC sperm compared with fertilization rates, embryo quality, and pregnancy.
  
  
  RESULTS
  Men with sperm DNA fragmentation at more than a diagnostic threshold of 25% had a high risk of infertility (OR: 117.33, 95% confidence interval [CI]: 12.72-2,731.84, RR: 8.75). Fertilization rates and embryo quality decreased as sperm DNA fragmentation increased in semen and DGC sperm. The risk of failure to achieve a pregnancy increased when sperm DNA fragmentation exceeded a prognostic threshold value of 52% for semen (OR: 76.00, CI: 8.69-1,714.44, RR: 4.75) and 42% for DGC sperm (OR: 24.18, CI: 2.89-522.34, RR: 2.16).
  
  
  CONCLUSIONS
  Sperm DNA testing by the alkaline Comet assay is useful for both diagnosis of male factor infertility and prediction of IVF outcome.
authors.affiliation: Centre for Public Health, Reproductive Medicine, Institute of Clinical Science, Queens University of Belfast, Northern Ireland, United Kingdom.
authors.forename: Luke
authors.initials: L
authors.lastname: Simon
authors.forename: Deborah
authors.initials: D
authors.lastname: Lutton
authors.forename: Joanne
authors.initials: J
authors.lastname: McManus
authors.forename: Sheena E M
authors.initials: SE
authors.lastname: Lewis
mesh_terms: D000328:Adult; D020552:Comet Assay / Q000379:methods*; D004249:DNA Damage / Q000502:physiology; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011379:Prognosis; D055101:Semen Analysis / Q000379:methods; D013094:Spermatozoa / Q000378:metabolism* / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult