Sperm deoxyribonucleic acid fragmentation index at the time of intracytoplasmic sperm injection and standard in vitro fertilization is correlated with lower fertilization but not with blastocyst genetic diagnosis

Alicia L Broussard; Benjamin Leader; Edna Tirado; Helena Russell; Hind Beydoun; Robert Colver; Laura Reuter; Bradford Bopp; Matthew Will; Erica Anspach Will; Glen Adaniya

doi:10.1016/j.xfre.2023.04.006

Sperm deoxyribonucleic acid fragmentation index at the time of intracytoplasmic sperm injection and standard in vitro fertilization is correlated with lower fertilization but not with blastocyst genetic diagnosis

F S Rep. 2023 Apr 25;4(2):183-189. doi: 10.1016/j.xfre.2023.04.006. eCollection 2023 Jun.

Authors

Affiliations

¹ Midwest Fertility Specialists, Carmel, Indiana.
² ReproSource, Marlborough, Massachusetts.
³ Eastern Virginia Medical School, Norfolk, Virginia.
⁴ Fort Belvoir Community Hospital, Fort Belvoir, Virginia.
⁵ Ovation Indianapolis, Indianapolis, Indiana.

Abstract

Objective: To determine the effects of sperm deoxyribonucleic acid (DNA) fragmentation at the time of fertilization on in vitro fertilization (IVF) outcomes and genetic diagnosis using next generation sequencing.

Design: Prospective double-blinded study.

Setting: Private Clinic.

Patients: Couples (n = 150).

Intervention: In vitro fertilization with preimplantation genetic testing for aneuploidy and sperm DNA fragmentation assay, as in sperm chromatin structure assay the day of retrieval.

Main outcome measures: Laboratory outcomes are listed in the results section. Statistical analysis was performed using JMP, XYLSTAT, and STATA version 15.

Results: The sperm DNA fragmentation index (DFI) in the neat ejaculate did not predict fertilization rate, quality, blastulation, or genetic diagnosis. No statistically significant results were obtained comparing <15% with >15%, <20% with >20%, <30% with >30% except for DFI. No statistically significant differences in oocyte source age or male age were observed. No statistically significant differences comparing <15% with >15%, <20% with >20%, <30% with >30% DFI at the time of standard IVF or intracytoplasmic sperm injection (ICSI) were observed for % euploid, aneuploid, mosaic, blastulation, biopsied, or D5/total biopsied. The DFI of >15% had more good quality D3 embryos than the <15% group, as did the >20% group compared with the <20% group. The ICSI fertilization was significantly higher in all 3 lower percentage groups compared with the higher counterpart. Standard IVF had significantly more blastocysts/fertilized suitable for biopsy and more D5/total number biopsied than ICSI embryos despite no difference in DFI.

Conclusions: The DFI at fertilization is correlated with decreased fertilization for ICSI and IVF.

Keywords: DFI; IVF outcomes; Preimplantation genetic testing; Sperm DNA fragmentation; fertilization.