Predictive value of DNA integrity analysis in idiopathic recurrent pregnancy loss following spontaneous conception.
OBJECTIVE
Standard semen parameters are poor predictors of fertility potential. To date, apart from, paternal karyotyping sperm factors are not evaluated in recurrent pregnancy loss (RPL), only recent studies have emphasized the role of sperm factors in early embryonic development as sperm transcribes genes critical for early embryonic development. Sperm DNA integrity is useful diagnostic and prognostic marker and has clinical implications in idiopathic recurrent pregnancy loss (iRPL) following spontaneous conception. The aim of this study was to assess DNA integrity in cases experiencing iRPL following spontaneous conception.


METHODS
Semen samples from 45 patients and 20 controls were analyzed as per WHO 1999 guidelines and sperm chromatin structure assay (SCSA) was used to measure DNA fragmentation index (DFI).


RESULTS
By applying receiver operating curve (ROC) analysis, sperm DFI of approximately 26 % was found in male partner of couples experiencing iRPL.


CONCLUSIONS
Our data indicate that sperm from men with a history of iRPL have a higher percentage of DNA damage as compared to control group, and this can explain pregnancy loss in these patients. Men with higher DFI are infertile whereas men with lower DFI (26 %) are able to conceive but experience recurrent pregnancy loss. Thus it is important to evaluate sperm DFI in couples experiencing iRPL to understand exact aetiology of RPL and determine prognosis and management.
Laboratory for Molecular Reproduction and Genetics, Department of Anatomy, All India Institute of Medical Sciences, New Delhi 29, India. kishlaykumar@gmail.com
Kishlay
K
Kumar
Deepika
D
Deka
Amar
A
Singh
D K
DK
Mitra
B R
BR
Vanitha
Rima
R
Dada
D000328:Adult; D016022:Case-Control Studies; D002843:Chromatin / Q000235:genetics; D053938:DNA Fragmentation; D020964:Embryo Loss / Q000235:genetics* / Q000473:pathology; D005260:Female; D005306:Fertilization / Q000235:genetics*; D006801:Humans; D007248:Infertility, Male; D007621:Karyotyping / Q000379:methods; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012372:ROC Curve; D012661:Semen / Q000166:cytology; D055101:Semen Analysis / Q000379:methods; D012680:Sensitivity and Specificity; D013094:Spermatozoa / Q000473:pathology*
D002843:Chromatin