title: Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage.
abstract: BACKGROUND
  Previous studies have described an association between sperm with DNA damage and a history of recurrent miscarriage (RM), although it is not clear whether there is benefit in screening for sperm DNA fragmentation and to what extent DNA fragmentation impacts upon RM.
  
  
  OBJECTIVE
  To identify what proportion of couples experiencing RM are affected by DNA fragmentation abnormalities.
  
  
  METHODS
  In this retrospective study, between 2008 and 2013, couples with a history of recurrent miscarriage (≥3 first trimester miscarriages) were investigated comprehensively for known causes (karyotype, uterine, antiphospholipid syndrome, thrombophilia) and also by semen analysis, including DNA fragmentation [sperm chromatin structure analysis (SCSA)]. Statistical analysis was performed on SPSS software with significance taken as P < 0.05.
  
  
  RESULTS
  There were 108 couples with a median sperm DNA fragmentation index (DFI) of 9.50%. Normal levels were found in 70.5% of men (DFI < 15%), 23% had high levels (DFI 15-30%), and 6.5% had very high levels (DFI > 30%). Couples with otherwise unexplained recurrent miscarriage had significantly higher DFI than those with other causes identified on routine screening (P = 0.012).
  
  
  CONCLUSIONS
  In couples experiencing RM, 30% (32/108) of men had sperm with high levels of DNA fragmentation (DFI > 15%). This may be a contributing factor to the clinical syndrome of RM, and future clinical trials of therapies for these couples are warranted.
authors.affiliation: University of New South Wales, Sydney, NSW, Australia.
authors.forename: Mikaela
authors.initials: M
authors.lastname: Leach
authors.affiliation: Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Aitken
authors.affiliation: University of New South Wales, Sydney, NSW, Australia.|St George Hospital, Kogarah, Sydney, NSW, Australia.|Royal Hospital for Women, Randwick, NSW, Australia.|IVFAustralia, Sydney, NSW, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Sacks
mesh_terms: D000026:Abortion, Habitual / Q000235:genetics*; D000328:Adult; D001315:Australia; D053938:DNA Fragmentation; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D013094:Spermatozoa
keywords: DNA Fragmentation; DNA damage; recurrent miscarriage; recurrent spontaneous abortion; sperm