Sperm DNA damage measured by the alkaline Comet assay as an independent predictor of male infertility and in vitro fertilization success.
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.
Simon
Luke
L
Centre for Public Health, Reproductive Medicine, Institute of Clinical Science, Queens University of Belfast, Northern Ireland, United Kingdom.
Lutton
Deborah
D
McManus
Joanne
J
Lewis
Sheena E M
SE
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