The association of sperm DNA fragmentation with embryological characteristics and effectiveness of assisted reproductive technology programs
Objective. To determine the relationship between sperm DNA integrity in the ejaculate, embryological parameters (oocyte fertilization rate; blastulation rate), clinical outcomes of assisted reproductive technology programs, and methods for sperm selection by hyaluronic acid binding.Dudarova A.Kh., Smolnikova V.Yu., Makarova N.P., Zobova A.V., Gorshinova V.K., Kalinina E.A., Naimi Z.
Subjects and methods. 67 married couples with a high rate of DNA fragmentation in the ejaculate of sexual partners, who had been treated using the in vitro fertilization/intracytoplasmic sperm injection ((IVF/ICSI) and IVF/physiological intracytoplasmic sperm injection (PICSI) programs, were examined during the prospective case-control study. The couples were divided into 2 groups according to the type of fertilization (ICSI, PICSI): 1) 37 couples who had ICSI; 2) 30 couples who had PICSI.
The investigators estimated the rate of sperm DNA fragmentation in the partner’s ejaculate and embryological parameters (oocyte fertilization rate; blastulation rate), and clinical outcomes of the IVF/ICSI programs with various methods for sperm selection.
The embryological parameters (oocyte fertilization rate; blastulation rate), clinical outcomes in the IVF/ICSI programs with various methods for sperm selection were also assessed.
Results. Our investigation showed that both groups had no statistically significant differences in the rates of oocyte fertilization and blastulation and in the number of early reproductive losses, which may be associated with a small sample size in the groups. However, there was an obvious trend toward an increase in clinical pregnancy rates in the group where sperm was selected by hyaluronate binding before an ICSI procedure. In addition, there were significant differences in live birth rates in favor of using the methods for the physiological selection of male gametes. According to our data, there are also significant differences in implantation rates between the ICSI and PICSI groups, demonstrating the direct relationship of the quality of embryos to the genetic adequacy of the gametes.
Conclusion. The choice of a fertilization technique for oocytes from a patient should be individualized. Determination of the rate of DNA fragmented sperm from a partner can serve as an additional test used in clinical practice to optimize the choice of methods for fertilization of oocytes from a female patient according to the type of sperm selection and to improve the efficiency of IVF programs as a whole.
Keywords
in vitro fertilization
infertility
hyaluronic acid
sperm selection
intracytoplasmic sperm injection
physiological intracytoplasmic sperm injection
assisted reproductive technologies
Supplementary Materials
- Table 1. Clinical and anamnestic data of patients included in the study
- Table 2. Hormonal profile of patients included in the study
- Table 3. Frequency of clinical pregnancy in the study groups
- Fig. 1. Distribution of sexual partners of the study groups by the percentage of fragmentation
- Fig. 2. Percentage ratio of different forms of pathozoospermia Patients with a high degree of DNA fragmentation in spermatozoa in I Group
- Fig. 3. Percentage Various forms of pathozoospermia Patients with a high degree of DNA fragmentation in spermatozoa in II Group
- Fig. 4. Distribution of developing pregnancy rate And live birth in the study groups
References
1. Sharma R., Biedenharn K.R., Fedor J.M., Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod. Biol. Endocrinol. 2013; 11: 66.
2. Dohle G.R., Diemer T., Givercman A., Jungwirth A., Kopa Z., Krausz C. Мужское бесплодие. Европейская ассоциация урологов; 2010.
3. Miyamoto T., Tsujimura A., Miyagawa Y., Koh E., Namiki M., Sengoku K. Male infertility and its causes in human. Adv. Urol. 2012; 2012: 384520.
4. Benchaib M., Braun V., Lornage J., Hadj S., Salle B., Lejeune H., Guérin J.F. Sperm DNA fragmentation decreases the pregnancy rate in an assisted reproductive technique. Hum. Reprod. 2003; 18(5): 1023-8.
5. Carrell D.T., Liu L., Peterson C.M., Jones K.P., Hatasaka H.H., Erickson L., Campbell B. Sperm DNA fragmentation is increased in couples with unexplained recurrent pregnancy loss. Arch. Androl. 2003; 49(1): 49-55.
6. Yagci A., Murk W., Stronk J., Huszar G. Spermatozoa bound to solid state hyaluronic acid show chromatin structure with high DNA chain integrity: an acridine orange fluorescence study. J. Androl. 2010; 31(6): 566-72.
7. Jakab A., Sakkas D., Delpiano E., Cayli S., Kovanci E., Ward D. et al. Intracytoplasmic sperm injection: a novel selection method for sperm with normal frequency of chromosomal aneuploidies. Fertil. Steril. 2005; 84(6): 1665-73.
8. Virro M.R., Larson-Cook K.L., Evenson D.P. Sperm chromatin structure assay (SCSA) parameters are related to fertilization, blastocyst development, and ongoing pregnancy in in vitro fertilization and intracytoplasmic sperm injection cycles. Fertil. Steril. 2004; 81(5): 1289-95.
9. Huszar G., Ozenci C.C., Cayli S., Zavaczki Z., Hansch E., Vigue L. Hyaluronic acid binding by human sperm indicates cellular maturity, viability, and unreacted acrosomal status. Fertil. Steril. 2003;79(Suppl. 3): 1616-24.
10. Findikli N., Kahraman S., Kumtepe Y., Donmez E., Benkhalifa M., Biricik A. et al. Assessment of DNA fragmentation and aneuploidy on poor quality human embryos. Reprod. Biomed. Online. 2004; 8(2): 196-206.
11. Seli E., Sakkas D. Spermatozoal nuclear determinants of reproductive outcome: implications for ART. Hum. Reprod. Update. 2005; 11(4): 337-49.
12. Brugnon F., Van Assche E., Verheyen G., Sion B., Boucher D., Pouly J.L. et al. Study of two markers of apoptosis and meiotic segregation in ejaculated sperm of chromosomal translocation carrier patients. Hum. Reprod. 2006; 21(3): 683-5.
13. Vorobyova O.A., Filatov M.V., Leontyeva O.A. The importance of analyzing the organization of chromatin nuclei of spermatozoa in the diagnosis of male infertility. Problemy reproduktsii. 1997; 4: 23-7. (in Russian)
14. Feskov A.M., Feskova I.A., Zhilkova E.S., Chumakova N.A., Somova E.V. Investigation of fragmentation of sperm DNA in men with high content of immature spermatozoa in the ejaculate. Svit meditsini ta biologii. 2012; 8(1): 179-82. (in Russian)
15. Feskov A.M., Feskova IA, Zhilkova E.S., Somova E.V., Zozulina A.N. The effect of DNA fragmentation and the disturbance of the process of maturation of spermatozoa on the degree of blastulation in the IVF program. Available at: www.uarm.org.ua (in Russian)
16. Guérin J.F., Benchaib M. Are IVF results predictable through the analysis of sperm DNA fragmentation? Gynecol. Obstet. Fertil. 2003; 31(12):1058-60.
17. Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum. Reprod. 2011; 26(6): 1270-83.
18. Worrilow K.C., Eid S., Matthews J., Pelts E., Khoury C., Liebermann J. Multi-site clinical trial evaluating PICSI, a method for selection of hyaluronan bound sperm (HBS) for use in ICSI: improved clinical outcomes.Нum. Reprod. 2010; 25 (Suppl. 1): i7.
19. Parmegiani L., Cognigni G.E., Ciampaglia W., Pocognoli P., Marchi F., Filicori M. Efficiency of hyaluronic acid (HA) sperm selection. J. Assist. Reprod. Genet. 2010; 27(1): 13-6.
20. Worrilow K.C., Huynh H.T., Bowers J.B., Anderson A., Schillings W., Crain J. PICSI versus ICSI: Statistically significant improvement in clinical outcomes in 240 in vitro fertilization (IVF) patients. Fertil. Steril. 2007; 88(Suppl. 1): S37.
21. Ovchinnikov R.I., Gamidov S.I., Popova A.Yu., Isbaev S.Kh., Ushakova I.V., Golubeva O.N. Causes of reproductive losses in men - fragmentation of the DNA of spermatozoa. Russian medical journal. 2015; 23(11): 634-8. (in Russian)
22. Gamidov S.I., Ovchinnikov R.I., Popova A.Yu., Golubeva O.N., Ushakova I.V. The role of men in the habitual miscarriage of a wife. Urologiya. 2016; Suppl. No. 1: 35-43. (in Russian)
Received 01.11.2016
Accepted 11.11.2016
About the Authors
Dudarova Alina Khasanovna, postgraduate of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics,Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: kanshaov85@mail.ru
SmolnikovaVeronikaYurievna, M.D, Ph.D, Senior Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: v_smolnikova@ oparina4.ru
Makarova Natalia Petrovna, PhD, Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: np.makarova@gmail.com
Zobova Anastasia Valerievna, PhD, Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: zoana2011@gmail.com
Gorshinova Viсtoria Konstantinovna, PhD, Researcher of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: chiasma@mail.ru
Kalinina Elena Anatolievna, M.D, Ph.D, The Head of the department of assisted reproductive technology in infertility treatment, Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381341. E-mail: e_kalinina@oparina4.ru
Naimi Zokhra Mokhamad Sami, graduate student of department of assisted reproductive technology in treating sterility, Research Center of Obstetrics,
Gynecology, and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382501. E-mail: naimi-zohra@mail.ru
For citations: Dudarova A.Kh., Smolnikova V.Yu., Makarova N.P., Zobova A.V.,
Gorshinova V.K., Kalinina E.A., Naimi Z. The association of sperm DNA fragmentation
with embryological characteristics and effectiveness of assisted reproductive technology programs. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 91-8. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.91-8
Similar Articles
