Correlation of sperm DNA damage with IVF and ICSI outcomes: A systematic review and meta-analysis
Open Access
- 4 October 2006
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Assisted Reproduction and Genetics
- Vol. 23 (9-10), 367-376
- https://doi.org/10.1007/s10815-006-9066-9
Abstract
Purpose: To assess the effects of sperm DNA damage, as determined by the TUNEL assay and the SCSA respectively, on the outcomes of IVF/ICSI treatment. Methods: A Medline search (from Jan 1978 to Apr 2006) was performed, together with a manual search of the bibliographies of retrieved original papers and review articles. 8 articles met all inclusion/exclusion criteria, of which, 5 used the TUNEL assay and the other 3 used the SCSA. All these articles were included in separate meta-analysis. The meta-analysis was conducted using the RevMan software with fixed-effect model or random-effects model. Results: As for articles using the TUNEL assay, the pooled results of IVF outcomes indicated that the clinical pregnancy rate (RR 0.68, 95% CI 0.54 to 0.85, P=0.006), but not the fertilization rate (RR 0.79, 95% CI 0.54 to 1.16, P=0.23) decreased significantly for patients with high degree of sperm DNA damage compared with those with low degree of sperm DNA damage. RRs of the ICSI outcomes indicated that there was no significant difference in either fertilization rate (RR 1.03, 95% CI 0.89 to1.18, P=0.70) or clinical pregnancy rate (RR 0.76, 95% CI 0.55 to 1.04, P=0.09) between these two groups. As for the SCSA papers, the pooled results showed no significant effects of sperm DNA damage on the clinical pregnancy rate after IVF (RR 0.58, 95% CI 0.25 to 1.31, P=0.19) or ICSI (RR 1.18, 95% CI 0.81 to 1.74, P=0.38). Conclusion(s): Our meta-analysis indicates that sperm DNA damage, as assessed by the TUNEL assay, significantly decreases only the chance of IVF clinical pregnancy, but not that of either IVF fertilization or ICSI fertilization or ICSI clinical pregnancy. Besides, our results also reveal that sperm DNA damage, when assessed by the SCSA, has no significant effect on the chance of clinical pregnancy after IVF or ICSI treatment.Keywords
This publication has 54 references indexed in Scilit:
- Sperm DNA damage assessment: a test whose time has comeFertility and Sterility, 2005
- Sperm DNA fragmentation negatively correlates with velocity and fertilization rates but might not affect pregnancy ratesFertility and Sterility, 2005
- Spermatozoal nuclear determinants of reproductive outcome: implications for ARTHuman Reproduction Update, 2005
- Measuring inconsistency in meta-analysesBMJ, 2003
- Correlations between two markers of sperm DNA integrity, DNA denaturation and DNA fragmentation, in fertile and infertile menFertility and Sterility, 2001
- The role of DNA strand breaks in human spermatozoa used for IVF and ICSIActa Obstetricia et Gynecologica Scandinavica, 2000
- Ultraviolet-Irradiated Spermatozoa Activate Oocytes but Arrest Preimplantation Development After Fertilization and Nuclear Transplantation in Cattle1Biology of Reproduction, 1999
- Sperm Deoxyribonucleic Acid Fragmentation is Increased in Poor-Quality Semen Samples and Correlates with Failed Fertilization in Intracytoplasmic Sperm InjectionFertility and Sterility, 1998
- Individuality of DNA denaturation patterns in human sperm as measured by the sperm chromatin structure assayReproductive Toxicology, 1991
- Meta-analysis in clinical trialsControlled Clinical Trials, 1986