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Can DNA fragmentation of neat or swim-up spermatozoa be used to predict pregnancy following ICSI of fertile oocyte donors？

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Asian Journal of Andrology 2013年第6期15卷 812-818,I0010页

作者： Jaime Gosálvez Pedro Caballero Carmen López-Fernández Leonor Ortega José Andrés Guijarro José Luís FernAndez Stephen D Johnston Rocio Nufiez-Calonge Faculty of Biology Autonomous University of Madrid Cantoblanco Madrid 28049 Spain CIfnica Tambre Madrid 28002 Spain GINIBIC-Complejo Hospitalario Universitario A CoruRa A Corufna15006 Spain School of Agriculture and Food Science The University of Queensland Gatton 4343 Australia

This study compared the potential of assessing sperm DNA fragmentation （SDF） from neat semen and the subsequent swim-up （SU） procedure to predict pregnancy when conducting ICSI of fertile donor oocytes. Infertile females （n=81） were transferred embryos resulting from intracytoplasmic sperm injection （ICSI） of their partner＇s spermatozoa and proven donor oocytes. This model normalized the impact of female factor in putative sperm DNA repair. Semen was blindly assessed for SDF using Halosperm immediately following ejaculation （NS） and after swim-up at the time of ICSI fertilisation. There was a decrease in SDF values of the ejaculated semen sample following the swim-up protocol （P=0.000）. Interestingly, pregnancy could be equally predicted from SDF values derived from either neat or swim-up semen samples. Receiver operator curves and the derived Youden＇s indices determined SDF cutoff values for NS and SU of 24.8% and 17.5%, respectively. Prediction of pregnancy from NS SDF had a sensitivity of 75% and a specificity of 69%, whereas for SU SDF was 78% and 73%, respectively. While increased levels of SDF negatively impact reproductive outcome, we have shown that a reduction in SDF following sperm selection using ICSI with proven donor oocytes is not mandatory for achieving pregnancy. This suggests that a certain level of DNA damage that is not detectable using current technologies could be impacting on the relative success of assisted reproductive technology （ART） procedures. Consequently, we propose a modification of the so called ＇iceberg model＇ as a possible rationale for understanding the role of SDF in reproductive outcome.

关键词： assisted reproductive technology egg donation male factor sperm DNA fragmentation

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