Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ASCO Annual Meeting 2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

2024 ASCO Annual Meeting

Keep up to date with all the top stories and latest evidence with our hub page, including official congress videos and expert takeaways.
ADVANCED SEARCH
Log in
Top
BMC Urology
Published in: BMC Urology 1/2023

Open Access 01-12-2023 | Infertility | Research article

Performing a sperm DNA fragmentation test in addition to semen examination based on the WHO criteria can be a more accurate diagnosis of IVF outcomes

Authors: Tsuyoshi Okubo, Noriyuki Onda, Teruaki Hayashi, Tatsuya Kobayashi, Kenji Omi, Tomoya Segawa

Published in: BMC Urology | Issue 1/2023

Login to get access

Abstract

Background

We analyzed the sperm DNA fragmentation index (DFI) and general semen test based on the World Health Organization (WHO) criteria and compared the two tests using semen factors. In addition, we examined whether DFI is a reliable parameter associated with in vitro fertilization (IVF) outcomes.

Methods

Sperm chromatin dispersion (SCD) and general semen tests were conducted in accordance with the WHO 2010 guidelines, and correlations between the two tests were investigated. The WHO criteria were set as the cutoff values for each of the following factors: semen volume, concentration, total sperm count, motility, and normal morphology, and compared with the DFI results.

Results

The subjects had a mean sperm DFI of 15.3% ± 12.6%, and the DFI increased with age. In contrast, motility and normal morphology decreased as the DFI increased. Patients who satisfied the WHO criteria in terms of concentration, total sperm count, and motility had a significantly lower DFI than those who did not satisfy the criteria. Therefore, evaluation with a general semen test based on the WHO criteria should be regarded as a qualitative evaluation of all factors other than semen volume and normal morphology.

Conclusions

High DFI (≥ 30%) caused a low blastocyst development rate following intracytoplasmic sperm injection. Male infertility due to DFI should be suspected when IVF results are poor despite normal semen findings based on the WHO criteria. The results of this study suggest that the SCD test may more accurately evaluate the correlation between IVF clinical outcomes and male infertility. Therefore, it is important to focus on DFI measurements.
Literature
1.
Softness KA, Trussler JT, Carrasquillo RJ. Advanced sperm testing. Curr Opin Urol. 2020;30(3):290–5.CrossRefPubMed
2.
Lopez G, Lafuente R, Checa MA, Carreras R, Brassesco M. Diagnostic value of sperm DNA fragmentation and sperm high-magnification for predicting outcome of assisted reproduction treatment. Asian J Androl. 2013;15(6):790–4.CrossRefPubMedPubMedCentral
3.
4.
Barratt CLR, Bjorndahl L, De Jonge CJ, Lamb DJ, Osorio Martini F, McLachlan R, Oates RD, van der Poel S, St John B, Sigman M, et al. The diagnosis of male infertility: an analysis of the evidence to support the development of global WHO guidance-challenges and future research opportunities. Hum Reprod Update. 2017;23(6):660–80.CrossRefPubMedPubMedCentral
5.
Kruger TF, Acosta AA, Simmons KF, Swanson RJ, Matta JF, Veeck LL, Morshedi M, Brugo S. New method of evaluating sperm morphology with predictive value for human in vitro fertilization. Urology. 1987;30(3):248–51.CrossRefPubMed
6.
Tavalaee M, Kiani-Esfahani A, Nasr-Esfahani MH. Relationship between phospholipase C-zeta, semen parameters, and chromatin status. Syst Biol Reprod Med. 2017;63(4):259–68.CrossRefPubMed
7.
Lu JC, Jing J, Chen L, Ge YF, Feng RX, Liang YJ, Yao B. Analysis of human sperm DNA fragmentation index (DFI) related factors: a report of 1010 subfertile men in China. Reprod Biol Endocrinol. 2018;16(1):23.CrossRefPubMedPubMedCentral
8.
9.
Yang H, Li G, Jin H, Guo Y, Sun Y. The effect of sperm DNA fragmentation index on assisted reproductive technology outcomes and its relationship with semen parameters and lifestyle. Transl Androl Urol. 2019;8(4):356–65.CrossRefPubMedPubMedCentral
10.
11.
Petersen CG, Mauri AL, Vagnini LD, Renzi A, Petersen B, Mattila M, Comar V, Ricci J, Dieamant F, Oliveira JBA, et al. The effects of male age on sperm DNA damage: an evaluation of 2,178 semen samples. JBRA Assist Reprod. 2018;22(4):323–30.PubMedPubMedCentral
12.
Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SE, Sharma R, Humaidan P. Sperm DNA fragmentation testing Summary evidence and clinical practice recommendations. Andrologia. 2021;53(2): e13874.CrossRefPubMed
13.
Tandara M, Bajic A, Tandara L, Bilic-Zulle L, Sunj M, Kozina V, Goluza T, Jukic M. Sperm DNA integrity testing: big halo is a good predictor of embryo quality and pregnancy after conventional IVF. Andrology. 2014;2(5):678–86.CrossRefPubMed
14.
Le MT, Nguyen TAT, Nguyen HTT, Nguyen TTT, Nguyen VT, Le DD, Nguyen VQH, Cao NT. Does sperm DNA fragmentation correlate with semen parameters? Reprod Med Biol. 2019;18(4):390–6.CrossRefPubMedPubMedCentral
15.
Tesarik J, Greco E, Mendoza C. Late, but not early, paternal effect on human embryo development is related to sperm DNA fragmentation. Hum Reprod. 2004;19(3):611–5.CrossRefPubMed
16.
Agarwal A, Panner Selvam MK, Baskaran S, Cho CL. Sperm DNA damage and its impact on male reproductive health: a critical review for clinicians, reproductive professionals and researchers. Expert Rev Mol Diagn. 2019;19(6):443–57.CrossRefPubMed
17.
Rosiak-Gill AGK, Jakubik J, Fraczek M, Patorski L, Gaczarzewicz D, Kurzawa R, Kurpisz M, Piasecka M. Age-related changes in human sperm DNA integrity. Aging. 2019;11(15):5399–411.CrossRefPubMedPubMedCentral
18.
19.
Evenson DP. Evaluation of sperm chromatin structure and DNA strand breaks is an important part of clinical male fertility assessment. Transl Androl Urol. 2017;6(Suppl 4):S495–500.CrossRefPubMedPubMedCentral
20.
Albani ECS, Gurrieri B, Arruzzolo L, Negri L, Borroni EM, Levi-Setti PE. Male age negative impact on sperm DNA fragmentation. Aging. 2019;11(9):2749–61.CrossRefPubMedPubMedCentral
21.
Silver EW, Eskenazi B, Evenson DP, Block G, Young S, Wyrobek AJ. Effect of antioxidant intake on sperm chromatin stability in healthy nonsmoking men. J Androl. 2005;26(4):550–6.CrossRefPubMed
22.
Shi X, Chan CPS, Waters T, Chi L, Chan DYL, Li TC. Lifestyle and demographic factors associated with human semen quality and sperm function. Syst Biol Reprod Med. 2018;64(5):358–67.CrossRefPubMed
23.
Ketheeswaran S, Pors SE, Zuniga Jara LA, Lemser CE, Hoj TK, Botkjaer JA, Christensen P, Humaidan P, Kristensen SG. Effect of whey protein supplementation on sperm quality and fertility in male mice. Food Chem Toxicol. 2020;141: 111366.CrossRefPubMed
24.
Vinnakota C, Cree L, Peek J, Morbeck DE. Incidence of high sperm DNA fragmentation in a targeted population of subfertile men. Syst Biol Reprod Med. 2019;65(6):451–7.CrossRefPubMed
25.
Green KA, Patounakis G, Dougherty MP, Werner MD, Scott RT Jr, Franasiak JM. Sperm DNA fragmentation on the day of fertilization is not associated with embryologic or clinical outcomes after IVF/ICSI. J Assist Reprod Genet. 2020;37(1):71–6.CrossRefPubMed
26.
Lin MH, Kuo-Kuang Lee R, Li SH, Lu CH, Sun FJ, Hwu YM. Sperm chromatin structure assay parameters are not related to fertilization rates, embryo quality, and pregnancy rates in in vitro fertilization and intracytoplasmic sperm injection, but might be related to spontaneous abortion rates. Fertil Steril. 2008;90(2):352–9.CrossRefPubMed
27.
28.
Westerman R. Biomarkers for demographic research: sperm counts and other male infertility biomarkers. Biodemography Soc Biol. 2020;65(1):73–87.CrossRefPubMed
29.
Colasante A, Minasi MG, Scarselli F, Casciani V, Zazzaro V, Ruberti A, Greco P, Varricchio MT, Greco E. The aging male: relationship between male age, sperm quality and sperm DNA damage in an unselected population of 3124 men attending the fertility centre for the first time. Arch Ital Urol Androl. 2019;90(4):254–9.CrossRefPubMed
30.
Wright C, Milne S, Leeson H. Sperm DNA damage caused by oxidative stress modifiable clinical, lifestyle and nutritional factors in male infertility. Reprod Biomed Online. 2014;28(6):684–703.CrossRefPubMed
31.
Tsuyoshi Okubo KH, Hayashi T, Onda N, Matsuo R, Omi K, Segawa T. Evaluation of motility and DNA fragmentation of sperm purified by microfluidics and Migration-Gravity sedimentation. J Mamm Ova Res. 2020;37(2):107–11.
32.
Shirota K, Yotsumoto F, Itoh H, Obama H, Hidaka N, Nakajima K, Miyamoto S. Separation efficiency of a microfluidic sperm sorter to minimize sperm DNA damage. Fertil Steril. 2016;105(2):315-321 e311.CrossRefPubMed
33.
Yamanaka M, Tomita K, Hashimoto S, Matsumoto H, Satoh M, Kato H, Hosoi Y, Inoue M, Nakaoka Y, Morimoto Y. Combination of density gradient centrifugation and swim-up methods effectively decreases morphologically abnormal sperms. J Reprod Dev. 2016;62(6):599–606.CrossRefPubMedPubMedCentral
34.
Makkar GNH, Yeung SB, Ho PC. Comparison of two colloidal silica-based sperm separation media with a non–silica-based medium. Fertil Steril. 1999;72(5):796–802.CrossRefPubMed
35.
Matsuura R, Takeuchi T, Yoshida A. Preparation and incubation conditions affect the DNA integrity of ejaculated human spermatozoa. Asian J Androl. 2010;12(5):753–9.CrossRefPubMedPubMedCentral
Metadata
Title
Performing a sperm DNA fragmentation test in addition to semen examination based on the WHO criteria can be a more accurate diagnosis of IVF outcomes
Authors
Tsuyoshi Okubo
Noriyuki Onda
Teruaki Hayashi
Tatsuya Kobayashi
Kenji Omi
Tomoya Segawa
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2023
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-023-01257-y

Other articles of this Issue 1/2023

BMC Urology 1/2023 Go to the issue

Research

Can pelvic diameter measurement have an effect on surgical outcomes in radical cystectomy?

Case Report

Retroperitoneal urothelial carcinoma arising after bladder diverticulectomy: a case report

Research

Chronic prednisone, metformin, and nonsteroidal anti-inflammatory drug use and clinical outcome in a cohort of bladder cancer patients undergoing radical cystectomy in Québec, Canada

Research

A comparative study of flexible ureteroscopic lithotripsy for upper urinary tract stones in patients with prior urosepsis following emergency drainage via retrograde ureteral stent or percutaneous nephrostomy

Research

Concerns about stone free rate and procedure events of percutaneous nephrolithotripsy (PCNL) for 2–4 cm kidney stones by standard-PCNL vs mini-PCNL- comparative randomised study

Research

Prostate cancer risk prediction based on clinical factors and prostate-specific antigen