Hum. Reprod. Advance Access originally published online on April 29, 2004
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Human Reproduction, Vol. 19, No. 6, 1409-1417,
June 2004
© 2004 European Society of Human Reproduction and Embryology
Full-term pregnancies achieved with ICSI despite high levels of sperm chromatin damage
1 Laboratory of Seminology and Reproductive Immunology, Department of Medical Pathophysiology and 4 Chair of Health Statistics, Department of Experimental Medicine, University of Rome ‘La Sapienza’, 2 Section of Toxicology and Biomedical Sciences, ENEA CR Casaccia and 3 ART Unit, CID, Rome, Italy
5 To whom correspondence should be addressed. e-mail: loredana.gandini{at}uniroma1.it
BACKGROUND: Sperm DNA integrity is essential for the accurate transmission of genetic information. The clinical significance of this assessment lies in its association with not only natural conception rates, but also the success of assisted reproduction technology (ART). It has been reported that sperm chromatin structure assay (SCSA) identified thresholds for negative pregnancy outcome after ART when the DNA fragmentation index (DFI), previously known as COMP
t, was >30%. METHODS: In a prospective clinical study, we examined 34 male infertile patients, the husbands of women undergoing conventional IVF or ICSI. SCSA and ART were carried out on semen aliquots taken from the same ejaculate. Fertilization rate, embryo quality and pregnancy rates were correlated to SCSA parameters, DFI and highly DNA stainable (HDS) cells. RESULTS: No differences were seen in SCSA parameter values between patients initiating pregnancies and not doing so in either ICSI or conventional IVF. Pregnancies and normal delivery were obtained even with high levels of DFI. CONCLUSIONS: There is still controversy over whether analytical techniques currently in use are able to identify the level of damage to spermatozoa. Large-scale studies should be conducted in different clinical settings to determine the effects of sperm DNA damage on the outcome of ART.
Key words: chromatin damage/ICSI/IVF/sperm chromatin/structure assay
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