title: Sperm DNA fragmentation and mitochondrial membrane potential combined are better for predicting natural conception than standard sperm parameters.
abstract: OBJECTIVE
  To evaluate whether DNA fragmentation and/or mitochondrial membrane potential (MMP) predict natural conception better than standard sperm parameters.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Eighty-five infertile and 51 fertile men.
  
  
  METHODS
  Assessment of sperm DNA fragmentation, MMP, and standard semen parameters over a 6- to 12-month observation period.
  
  
  METHODS
  Comparison between the results of DNA fragmentation, MMP, and standard sperm parameters alone or combined and achievement of natural conception.
  
  
  RESULTS
  Twenty-six of the 85 (31%) men from infertile couples conceived naturally. The median values of DNA fragmentation and MMP in the men who conceived within the observation period were similar to those in the fertile controls. Optimal threshold values of DNA fragmentation and MMP were 25% as determined by receiver operating characteristic analysis (area under the curve [AUC], 0.70; 95% confidence interval (CI) 0.58-0.82) and 62.5% (AUC, 0.68, 95% CI 0.56-0.80), respectively. The men in the infertile group with values of DNA fragmentation ≤25% and with MMP values ≥62.5% had significantly higher odds for conception (odds ratio [OR], 5.22; 95% CI 1.82-14.93] and OR, 4.67; 95% CI 1.74-12.5, respectively). Normal semen analysis alone had no predictive value for natural conception (OR, 1.84; 95% CI 0.67-5.07]). Both sperm function tests combined had significant odds for natural conception (OR, 8.24; 95% CI 2.91-23.33]), with a probability of 0.607 (60.7%) for both normal values and 0.158 (15.8%) for abnormal values.
  
  
  CONCLUSIONS
  Sperm DNA fragmentation and MMP combined may be superior to standard semen parameters for the prediction of natural conception.
authors.affiliation: Andrology Unit, Reproductive Unit, Department of Obstetrics and Gynecology, University Medical Center, Ljubljana, Slovenia.
authors.forename: Slađana
authors.initials: S
authors.lastname: Malić Vončina
authors.affiliation: Andrology Unit, Reproductive Unit, Department of Obstetrics and Gynecology, University Medical Center, Ljubljana, Slovenia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Golob
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Alojz
authors.initials: A
authors.lastname: Ihan
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Andreja Nataša
authors.initials: AN
authors.lastname: Kopitar
authors.affiliation: Andrology Unit, Reproductive Unit, Department of Obstetrics and Gynecology, University Medical Center, Ljubljana, Slovenia.
authors.forename: Mojca
authors.initials: M
authors.lastname: Kolbezen
authors.affiliation: Andrology Unit, Reproductive Unit, Department of Obstetrics and Gynecology, University Medical Center, Ljubljana, Slovenia. Electronic address: branko.zorn@kclj.si.
authors.forename: Branko
authors.initials: B
authors.lastname: Zorn
mesh_terms: D000328:Adult; D019540:Area Under Curve; D016022:Case-Control Studies; D048430:Cell Shape; D003430:Cross-Sectional Studies; D053938:DNA Fragmentation; D005260:Female; D005298:Fertility; D005306:Fertilization; D006801:Humans; D007248:Infertility, Male / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008297:Male; D053078:Membrane Potential, Mitochondrial; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D012372:ROC Curve; D055101:Semen Analysis / Q000379:methods*; D013076:Sperm Count; D013081:Sperm Motility; D013094:Spermatozoa / Q000378:metabolism / Q000473:pathology*; D055815:Young Adult
keywords: Male infertility; natural conception; semen analysis; sperm DNA fragmentation; sperm mitochondrial membrane potential