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Hum. Reprod. Advance Access published online on August 29, 2008
Human Reproduction, doi:10.1093/humrep/den321
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© The Author 2008. 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@oxfordjournals.org

Sperm DNA damage is associated with an increased risk of pregnancy loss after IVF and ICSI: systematic review and meta-analysis

Armand Zini1,4, Jason M. Boman1, Eric Belzile2 and Antonio Ciampi2,3

1 Division of Urology, Department of Surgery, St Mary's Hospital Center, Mary's Hospital, 3830 Lacombe Avenue, Montreal, Quebec, Canada H3T 1M5 2 Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Center, Mary's Hospital, 3830 Lacombe Avenue, Montreal, Quebec, Canada H3T 1M5 3 Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada

4 Correspondence address. Fax: +1-514-734-2718; E-mail: ziniarmand{at}yahoo.com

BACKGROUND: Sperm DNA damage is common amongst infertile men and may adversely impact natural reproduction, IUI-assisted reproduction and to a lesser degree IVF pregnancy. The aim of this study was to examine the influence of sperm DNA damage on the risk of spontaneous pregnancy loss after IVF and ICSI.

METHODS: We conducted a systematic review and meta-analysis of studies on sperm DNA damage and pregnancy loss after an IVF and/or ICSI pregnancy.

RESULTS: Two by two tables were constructed and odds ratios (ORs) were derived from 11 estimates of pregnancy loss (five IVF and six ICSI studies from seven reports). These 11 studies involved 1549 cycles of treatment (808 IVF and 741 ICSI cycles) with 640 pregnancies (345 IVF and 295 ICSI) and 122 pregnancy losses. The combined OR of 2.48 (95% CI 1.52, 4.04, P < 0.0001) indicates that sperm DNA damage is predictive of pregnancy loss after IVF and ICSI.

CONCLUSIONS: In conclusion, sperm DNA damage is associated with a significantly increased risk of pregnancy loss after IVF and ICSI. These data provide a clinical indication for the evaluation of sperm DNA damage prior to IVF or ICSI and a rationale for further investigating the association between sperm DNA damage and pregnancy loss.

Key words: spermatozoa/DNA damage/pregnancy loss/miscarriage/male infertility/in vitro fertilization

Submitted on June 2, 2008; resubmitted on July 2, 2008; accepted on July 24, 2008.


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