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Hum. Reprod. Advance Access originally published online on April 29, 2004
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Human Reproduction, Vol. 19, No. 6, 1385-1394, June 2004
© 2004 European Society of Human Reproduction and Embryology

An algorithm to predict pregnancy in assisted reproduction

S.E.M. Lewis1,4, M. O’Connell1, M. Stevenson2, L. Thompson-Cree1 and N. McClure1,3

1 School of Medicine, Obstetrics & Gynaecology, Queen’s University, Belfast BT12 6BJ, 2 Epidemiology and Public Health, Queen’s University Belfast, Belfast BT12 6BA and 3 Regional Fertility Centre, Royal-Jubilee Maternity Service, Belfast BT12 6BJ, UK S.E.M.Lewis and M.O’Connell contributed equally to this work.

4 To whom correspondence should be addressed. e-mail: s.e.lewis{at}qub.ac.uk

BACKGROUND: Male fertility potential cannot be measured by conventional parameters for the assisted reproduction technique; ICSI. This study determines the relationship between testicular and ejaculated sperm mitochondrial (mt) DNA deletions, nuclear (n) DNA fragmentation, and fertilization and pregnancy rates in ICSI. METHODS: Ejaculated sperm were obtained from 77 men and testicular sperm from 28 men with obstructive azoospermia undergoing ICSI. Testicular sperm were retrieved using a Trucut needle. mtDNA was analysed using a long PCR. The alkaline Comet assay determined nDNA fragmentation. RESULTS: Of subjects who achieved a pregnancy (50%) using testicular sperm, only 26% had partners’ sperm with wild-type (WT) mtDNA. Of pregnant subjects (38%) using ejaculated sperm, only 8% had partner sperm with WT mtDNA. In each, the successful group had less mtDNA deletions and less nDNA fragmentation. There were inverse relationships between pregnancy and mtDNA deletion numbers, size and nDNA fragmentation for both testicular and ejaculated sperm. No relationships were observed with fertilization rates. An algorithm for the prediction of pregnancy is presented based on the quality of sperm nDNA and mtDNA. CONCLUSION: In both testicular and ejaculated sperm, mtDNA deletions and nDNA fragmentation are closely associated with pregnancy in ICSI.

Key words: fertilization/human testicular and ejaculated sperm/mitochondrial DNA/nuclear DNA/pregnancy


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