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Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: a meta-analysis

Journal of Assisted Reproduction and Genetics volume 32, pages 17–26 (2015)Cite this article

Abstract

Purpose

The purpose of this study was to carry out a meta-analysis for a comprehensive understanding and estimation of the association between sperm DNA Fragmentation Index (DFI) and pregnancy outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.

Methods

Studies concerning the link of DFI with pregnancy outcome were included after literature search of database PUBMED, EMBASE, MEDLINE. Related information was extracted from the eligible studies by two independent authors and a meta-analysis was conducted by using STATA 12.0 software. Pregnancy outcomes consisted of biochemical pregnancy (BP), clinical pregnancy (CP) and pregnancy loss (PL). The studies included for meta-analysis were divided into three groups according to the DFI threshold value (DFI >27 %, 15–27 %, ≤15 % group). The odds ratio (OR ) and their 95 % confidence intervals (95 % CIs) were used to evaluate the association between DFI and pregnancy outcome.

Results

Twenty articles were included in our meta-analysis. The results indicated that infertile couples were more likely to get pregnant if DFI was less than threshold value (For threshold value > 27 % and 15–27 % group, combined overall OR (95 % CI) = 1.437 (1.186–1.742), 1.639 (1.093–2.459) respectively). However, when stratified by DFI detection methods, using sperm chromatin structure assay (SCSA) as the DFI test method, the results indicated a similar CP rate between groups with a high DFI or a lower DFI value (SCSA, For threshold value >27 % and 15–27 % group, combined overall OR (95 % CI) = 1.242(0.978–1.577), 1.480(0.921–2.377) respectively). The meta-analysis based on BP (overall OR (95 % CI) = 0.952 (0.697–1.302)) and PL((For DFI >27 %, 15–27 %, ≤15 % group, OR (95 % CI) = 0.786 (0.491–1.258), 1.509 (0.655–3.476), (0.538 (0.264–1.097) respectively) outcome yielded nonsignificant results.

Conclusions

The predication value of DFI for IVF or ICSI outcome is not confirmed in our meta-analysis. Further better designed studies with larger subjects involved are needed to better address this issue.

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Acknowledgments

The study was supported by the National Natural Science Foundation of China (No. 81170563 and 81270694).

Conflict of interest

All authors declare no competing financial interests.

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Affiliations

  1. Department of Andrology, Drum tower Hospital, Nanjing University, #321 Zhong Shan Road, Nanjing, 210008, China

    Zheng Zhang, Leilei Zhu, Hesong Jiang, Hai Chen, Yun Chen & Yutian Dai

Authors
  1. Zheng Zhang
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  2. Leilei Zhu
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  3. Hesong Jiang
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  4. Hai Chen
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  5. Yun Chen
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  6. Yutian Dai
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Corresponding author

Correspondence to Yutian Dai.

Additional information

Capsule DFI is an important value to assess human sperm quality, but this meta-analysis found no association between DFI and pregnancy outcome after IVF or ICSI.

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Zhang, Z., Zhu, L., Jiang, H. et al. Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: a meta-analysis. J Assist Reprod Genet 32, 17–26 (2015). https://doi.org/10.1007/s10815-014-0374-1

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  • DOI: https://doi.org/10.1007/s10815-014-0374-1

Keywords

  • DNA fragmentation index
  • Pregnancy
  • Meta-analysis
  • In vitro fertilization
  • Intracytoplasmic sperm injection