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Hum. Reprod. Advance Access published online on April 29, 2004
Human Reproduction, doi:10.1093/humrep/deh280
© 2004 by European Society of Human Reproduction and Embryology
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Received January 9, 2004
Accepted March 31, 2004

Article

The predictive value of sperm chromatin structure assay (SCSA) parameters for the outcome of intrauterine insemination, IVF and ICSI

M. Bungum 1*, P. Humaidan 1, M. Spano 2, K. Jepson 3, L. Bungum 1, A. Giwercman 3

1 Fertility Clinic, Viborg Hospital (Skive), Resenvej 25, DK 7800 Skive, Denmark
2 Section of Toxicology and Biomedical Sciences, BIOTEC-MED, ENEA Casaccia Research Center, Rome, Italy
3 Fertility Centre, Scanian Andrology Centre, Malmö University Hospital, Malmö, Sweden

* To whom correspondence should be addressed. E-mail: mona.bungum{at}sygehusviborg.dk.


  Abstract

INTRODUCTION: Sperm chromatin integrity assessment has been suggested as a fertility predictor. The aim of this study was to examine the relationship between the results of sperm chromatin structure assay (SCSA) and the outcome of IVF, ICSI and intrauterine insemination (IUI). METHODS: A total of 306 consecutive couples undergoing assisted reproduction were included. IUI was performed in 131, IVF in 109 and ICSI in 66. SCSA results were expressed as DNA fractionation index (DFI) and highly DNA stainable (HDS) cell fractions. Reproductive outcome parameters were biochemical pregnancy (BP), clinical pregnancy (CP) and delivery (D). RESULTS: For IUI, the chance of pregnancy/delivery was significantly higher in the group with DFI <=27% and HDS <=10% than in patients with DFI >27% or HDS >10%. The odds ratios (ORs) (95% confidence intervals) were 20 (2.3-117), 16 (1.9-137) and 14 (1.6-110) for BP, CP and D, respectively. No statistical difference between the outcomes of IVF versus ICSI was observed in the group with DFI <=27%. In the DFI >27% group, however, the results of ICSI were significantly better than those of IVF. Comparing ICSI with IVF, the OR (95% CI) for BP was 26 (1.9-350). CONCLUSIONS: SCSA is a useful method for prediction of the outcome of assisted reproduction.

Key words: Key words: ART/DNA damage/pregnancy rate/sperm chromatin


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