Measuring Sperm DNA Fragmentation and Clinical Outcomes of Medically Assisted Reproduction: A Systematic Review and Meta-Analysis

Autor: Geert Hamer, I. Scholten, Sjoerd Repping, Madelon van Wely, M. Cissen, Ben W.J. Mol, Jan Bruin, Steven A. Mansell, Didi D.M. Braat
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Pregnancy Rate
Physiology
Maternal Health
Gene Expression
lcsh:Medicine
DNA fragmentation
Biochemistry
Mathematical and Statistical Techniques
0302 clinical medicine
Pregnancy
Animal Cells
Medicine and Health Sciences
lcsh:Science
reproductive and urinary physiology
Collection Review
030219 obstetrics & reproductive medicine
Multidisciplinary
TUNEL assay
medicine.diagnostic_test
Chromosome Biology
Obstetrics and Gynecology
Research Assessment
Spermatozoa
Chromatin
Body Fluids
Women's cancers Radboud Institute for Health Sciences [Radboudumc 17]
Nucleic acids
Physical Sciences
Female
Epigenetics
Comet Assay
Cellular Types
Anatomy
Statistics (Mathematics)
Embryo quality
Systematic Reviews
Context (language use)
Fertilization in Vitro
Semen analysis
Biology
Research and Analysis Methods
Andrology
03 medical and health sciences
Semen
In Situ Nick-End Labeling
Genetics
medicine
Humans
Statistical Methods
urogenital system
lcsh:R
Biology and Life Sciences
Cell Biology
DNA
Sperm
Abortion
Spontaneous
Semen Analysis
Comet assay
Pregnancy rate
Germ Cells
030104 developmental biology
Women's Health
DNA damage
lcsh:Q
Mathematics
Meta-Analysis
Zdroj: PLoS ONE, Vol 11, Iss 11, p e0165125 (2016)
PLoS One, 11
PLoS One, 11, 11
PLoS ONE
ISSN: 1932-6203
Popis: Contains fulltext : 170951.PDF (Publisher’s version ) (Open Access) Sperm DNA fragmentation has been associated with reduced fertilization rates, embryo quality, pregnancy rates and increased miscarriage rates. Various methods exist to test sperm DNA fragmentation such as the sperm chromatin structure assay (SCSA), the sperm chromatin dispersion (SCD) test, the terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate nick end labelling (TUNEL) assay and the single cell gel electrophoresis (Comet) assay. We performed a systematic review and meta-analysis to assess the value of measuring sperm DNA fragmentation in predicting chance of ongoing pregnancy with IVF or ICSI. Out of 658 unique studies, 30 had extractable data and were thus included in the meta-analysis. Overall, the sperm DNA fragmentation tests had a reasonable to good sensitivity. A wide variety of other factors may also affect the IVF/ICSI outcome, reflected by limited to very low specificity. The constructed hierarchical summary receiver operating characteristic (HSROC) curve indicated a fair discriminatory capacity of the TUNEL assay (area under the curve (AUC) of 0.71; 95% CI 0.66 to 0.74) and Comet assay (AUC of 0.73; 95% CI 0.19 to 0.97). The SCSA and the SCD test had poor predictive capacity. Importantly, for the TUNEL assay, SCD test and Comet assay, meta-regression showed no differences in predictive value between IVF and ICSI. For the SCSA meta-regression indicated the predictive values for IVF and ICSI were different. The present review suggests that current sperm DNA fragmentation tests have limited capacity to predict the chance of pregnancy in the context of MAR. Furthermore, sperm DNA fragmentation tests have little or no difference in predictive value between IVF and ICSI. At this moment, there is insufficient evidence to recommend the routine use of sperm DNA fragmentation tests in couples undergoing MAR both for the prediction of pregnancy and for the choice of treatment. Given the significant limitations of the evidence and the methodological weakness and design of the included studies, we do urge for further research on the predictive value of sperm DNA fragmentation for the chance of pregnancy after MAR, also in comparison with other predictors of pregnancy after MAR.
Databáze: OpenAIRE
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