Document Detail

Redefining the relationship between sperm deoxyribonucleic acid fragmentation as measured by the sperm chromatin structure assay and outcomes of assisted reproductive techniques.
MedLine Citation:
PMID:  16084876     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To test the hypothesis that couples with sperm chromatin structure assay (SCSA) DNA fragmentation index (DFI) values >27% would not achieve pregnancy with assisted reproductive techniques (ART) and to investigate how DFI and high DNA stainability (HDS), as measured by the SCSA, affect fertilization, cleavage, implantation, and pregnancy rates in IVF cycles. DESIGN: Prospective clinical study. SETTING: Academic human reproduction laboratory. PATIENT(S): One hundred couples undergoing IVF with conventional insemination or intracytoplasmic sperm injection. INTERVENTION(S): Testing with SCSA was performed by SCSA Diagnostics (Brookings, South Dakota) on a semen aliquot taken from ejaculate used for ART. MAIN OUTCOME MEASURE(S): Relating total DFI and HDS to conventional semen parameters and cycle-specific outcomes after ART. RESULT(S): Nine of nineteen couples achieved clinical pregnancy when DFI was > or =27%, and 2 of 22 couples achieved clinical pregnancy when DFI was < or =9%. One of nine couples achieved clinical pregnancy with HDS >17%. The DFI was negatively correlated with sperm density (r = -0.23, P<.03) and motility (r = -0.55, P<.00), and HDS was negatively correlated with sperm density (r = -0.37, P<.00). CONCLUSION(S): Sperm chromatin structure assay failed to identify elevated DFI thresholds for negative pregnancy outcome after ART. Patients with low DFI (< or =9%) were least likely to become pregnant, which is also contradictory to SCSA marketing, which states that DFIs of < or =15% have excellent fertility potential. Patients with HDS > or =17% had low pregnancy rates, indicating decreased fertility potential, which deserves further investigation. Larger studies are necessary to confirm that low DFI is associated with decreased fertility and, if proved, might redefine the use of the SCSA in evaluating infertility.
John F Payne; Douglas J Raburn; Grace M Couchman; Thomas M Price; Margaret G Jamison; David K Walmer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Fertility and sterility     Volume:  84     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-08     Completed Date:  2005-12-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  United States    
Other Details:
Languages:  eng     Pagination:  356-64     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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MeSH Terms
Chromatin / physiology*
DNA Fragmentation / physiology*
Linear Models
Middle Aged
Prospective Studies
Reproductive Techniques, Assisted*
Sperm Motility / physiology*
Spermatozoa / physiology*
Reg. No./Substance:
Comment In:
Fertil Steril. 2006 Mar;85(3):809; author reply 809-10   [PMID:  16500373 ]
Fertil Steril. 2006 Mar;85(3):810-1; author reply 811-2   [PMID:  16500374 ]

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