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Hum. Reprod. Advance Access originally published online on June 2, 2005
Human Reproduction 2005 20(9):2590-2594; doi:10.1093/humrep/dei091
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

ICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment

Ermanno Greco1, Stefania Romano1, Marcello Iacobelli1, Susanna Ferrero1, Elena Baroni1, Maria Giulia Minasi1, Filippo Ubaldi1, Laura Rienzi1 and Jan Tesarik2,3

1 Centre for Reproductive Medicine, European Hospital, Via Portuense 700, 00149 Rome, Italy and 2 MAR&Gen, Molecular Assisted Reproduction and Genetics, Gracia 36, 18002 Granada, Spain

3 To whom correspondence should be addressed. Email: cmendoza{at}ugr.es

BACKGROUND: Most studies examining the use of ICSI for cases of elevated sperm DNA fragmentation report poor pregnancy and implantation rates. ICSI with testicular sperm samples has recently been suggested for these cases. Here we test a less invasive approach based on oral antioxidant treatment prior to ICSI with ejaculated spermatozoa. METHODS: Thirty-eight men with an elevated (≥15%) percentage of DNA-fragmented spermatozoa in the ejaculate were treated with antioxidants (1 g vitamin C and 1 g vitamin E daily) for 2 months after one failed ICSI attempt. In 29 (76%) of these cases this treatment led to a decrease in the percentage of DNA-fragmented spermatozoa, and a second ICSI attempt was performed. Outcomes of the two attempts were compared. RESULTS: No differences in fertilization and cleavage rates or in embryo morphology were found between the ICSI attempts performed before and after the antioxidant treatment. However, a marked improvement of clinical pregnancy (48.2% versus 6.9%) and implantation (19.6% versus 2.2%) rates was observed after the antioxidant treatment as compared with the pretreatment ICSI outcomes. CONCLUSIONS: Oral antioxidant treatment appears to improve ICSI outcomes in those patiens with sperm DNA damage, in whom this treatment reduces the percentage of damaged spermatozoa.

Key words: antioxidant treatment/ejaculated spermatozoa/ICSI/sperm DNA damage/sperm fertilizing ability


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