Sperm Chromatin Dispersion Test before Sperm Preparation Is Predictive of Clinical Pregnancy in Cases of Unexplained Infertility Treated with Intrauterine Insemination and Induction with Clomiphene Citrate
Autor: | Petra De Sutter, Frank Vandekerckhove, Jan Gerris, Ilse De Croo, Etienne Van den Abbeel |
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Jazyk: | angličtina |
Rok vydání: | 2016 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment media_common.quotation_subject Fertility DNA fragmentation WORLD-HEALTH-ORGANIZATION Biology Insemination TUBAL PATENCY ICSI PARAMETERS Andrology 03 medical and health sciences 0302 clinical medicine oxygen radicals Medicine and Health Sciences medicine FERTILITY SPERMATOZOA DNA-FRAGMENTATION STRUCTURE ASSAY METAANALYSIS Sperm motility Original Research Unexplained infertility media_common Gynecology lcsh:R5-920 Pregnancy receiver operating characteristic 030219 obstetrics & reproductive medicine In vitro fertilisation General Medicine medicine.disease Sperm chromatin dispersion test INTEGRITY 030220 oncology & carcinogenesis Medicine lcsh:Medicine (General) in vitro fertilization |
Zdroj: | FRONTIERS IN MEDICINE Frontiers in Medicine Frontiers in Medicine, Vol 3 (2016) |
ISSN: | 2296-858X |
DOI: | 10.3389/fmed.2016.00063 |
Popis: | Background/Aims: A large proportion of men with normal sperm results as analyzed using conventional techniques have fragmented DNA in their spermatozoa. We performed a prospective study to examine the incidence of DNA fragmentation in sperm in cases of couples with previously unexplained infertility and treated with intra-uterine insemination. We evaluated whether there was any predictive value of DNA fragmentation for pregnancy outcome in such couples. Methods: The percentage of DNA fragmentation and all classical variables to evaluate sperm before and after sperm treatment were determined. We studied the probable association between these results and pregnancy outcome in terms of clinical and ongoing pregnancy rate per started first cycle. We also assessed the optimal threshold level to diagnose DNA fragmentation in our center. Results: When using threshold levels of 20%, 25%, and 30%, the occurrence of DNA fragmentation was 42.9%, 33.3%, and 28.6%, respectively. Receiver operating characteristic (ROC) analysis of all cases revealed an area under the curve (AUC) of 80% to predict the clinical pregnancy rate per cycle from testing the sperm motility (a+b) before treatment. We failed to generate an ROC curve to estimate pregnancy outcome from the amount of DNA fragmentation before treatment. However, when selecting only those men with a pre-treatment DNA fragmentation of at least 20%, the pre-treatment result was statistically different between couples who achieved a clinical pregnancy and those who did not. Conclusion: DNA fragmentation is often diagnosed in couples with unexplained infertility. Each center should evaluate the type of test it uses to detect DNA fragmentation in sperm and determine its own threshold values. |
Databáze: | OpenAIRE |
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