The Effects of Sperm Parameters and Sperm DNA Damage on pregnancy outcomes of women undergoing intrauterine insemination

Abstract

In this study, we compared the effects of sperm parameters and sperm DNA damage on pregnancy outcomes of women undergoing intrauterine insemination (IUI) because of an ovulatory dysfunction (OD) and unexplained infertility (UEI). This study was retrospective, and semen samples were collected from records of 88 infertile couples referred to private clinic for infertility treatment from December 2019 to March 2020. The study has two groups: Groups 1: couples with UEI, and Group 2: fertile males with their partners having OD. The participants' age and body mass index (BMI) were 28.20 ± 3.08 and 25.45±2.25, respectively. In the control group,the pregnancy rate was 9/41 (%21.9), and one out of nine patients had a miscarriage. The pregnancy rate in the study group (UEI) was 8/47 (17%), and half of the pregnancies ended as miscarriage. Our results showed that sperm DNA damage increases the abortion rate but has not influenced the pregnancy rate in IUI.

Keywords

• sperm DNA damage
• pregnancy
• unexplained infertility
• intrauterine insemination

References

1. 1. Agarwal A, Panner Selvam MK, Baskaran S, Cho C-L. Sperm DNA damage and its impact on male reproductive health: a critical review for clinicians, reproductive professionals and researchers. Expert review of molecular diagnostics. 2019; 19(6): 443-57.
2. 2. Antonouli S, Papatheodorou A, Panagiotidis Y, Petousis S, Prapas N, Nottola SA, et al. The impact of sperm DNA fragmentation on ICSI outcome in cases of donated oocytes. Archives of gynecology and obstetrics. 2019; 300(1): 207-15.
3. 3. Beaud H, Tremblay AR, Chan PT, Delbes G. Sperm DNA damage in cancer patients. Genetic Damage in Human Spermatozoa: Springer; 2019; 189-203.
4. 4. Casanovas A, Ribas-Maynou J, Lara-Cerrillo S, Jimenez-Macedo AR, Hortal O, Benet J, et al. Double-stranded sperm DNA damage is a cause of delay in embryo development and can impair implantation rates. Fertility and sterility. 2019; 111(4): 699-707.
5. 5. Chen Q, Zhao J-Y, Xue X, Zhu G-X. The association between sperm DNA fragmentation and reproductive outcomes following intrauterine insemination, a meta analysis. Reproductive Toxicology. 2019;86:50-5.
6. 6. Colacurci N, De Leo V, Ruvolo G, Piomboni P, Caprio F, Pivonello R, et al. Recombinant FSH improves sperm DNA damage in male infertility: a phase II clinical trial. Frontiers in endocrinology. 2018; 9: 383.
7. 7. Deng C, Li T, Xie Y, Guo Y, Yang Qy, Liang X, et al. Sperm DNA fragmentation index influences assisted reproductive technology outcome: A systematic review and meta‐analysis combined with a retrospective cohort study. Andrologia. 2019; 51(6): e13263.
8. 8. Güngör K, Dokuzeylül Güngör N,Basar MM, Cengiz F, Ersahin SS, Cil K. Relationship between serum vitamin D level ,semen parameters and sperm DNA damage in men with unexplained infertility Eur Rew Med Pharmacol Sci 2022; 26(2): 499-505.

9. 9. Esteves SC. Interventions to prevent sperm DNA damage effects on reproduction. Genetic damage in human spermatozoa: Springer; 2019; 119-48.
10. 10. Gill K, Rosiak-Gill A, Jakubik J, Patorski L, Lukaszuk M, Piasecka M. The higher risk for sperm DNA damage in infertile men. Ginekologia polska. 2019; 90(12): 684-91.
11. 11. Esteves SC, Santi D, Simoni M. An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men. Andrology. 2020; 8(1): 53-81.
12. 12. Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods. 2007; 39(2): 175-91.
13. 13. Haddock L, Gordon S, Lewis SE, Larsen P, Shehata A, Shehata H. Sperm DNA fragmentation is a novel biomarker for early pregnancy loss. Reproductive BioMedicine Online. 2021; 42(1): 175-84.
14. 14. Kabukçu C, Çil N, Çabuş Ü, Alataş E. Effect of ejaculatory abstinence period on sperm DNA fragmentation and pregnancy outcome of intrauterine insemination cycles: A prospective randomized study. Archives of Gynecology and Obstetrics. 2021; 303(1): 269-78.
15. 15. Kim GY. What should be done for men with sperm DNA fragmentation? Clinical and experimental reproductive medicine. 2018; 45(3): 101.
16. 16. McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertility and sterility. 2019; 112(1): 54-60.
17. 17. Nicopoullos J, Vicens-Morton A, Lewis SE, Lee K, Larsen P, Ramsay J, et al. Novel use of COMET parameters of sperm DNA damage may increase its utility to diagnose male infertility and predict live births following both IVF and ICSI. Human Reproduction. 2019; 34(10): 1915-23.
18. 18. Paoli D, Pallotti F, Lenzi A, Lombardo F. Fatherhood and sperm DNA damage in testicular cancer patients. Frontiers in endocrinology. 2018; 9: 506.
19. 19. Ribas-Maynou J, Benet J. Single and double strand sperm DNA damage: different reproductive effects on male fertility. Genes. 2019; 10(2):105.
20. 20. Ribas‐Maynou J, Yeste M, Becerra‐Tomás N, Aston KI, James ER, Salas‐Huetos A. Clinical implications of sperm DNA damage in IVF and ICSI: updated systematic review and meta‐analysis. Biological Reviews. 2021; 96(4): 1284-300.
21. 21. Selvam MKP, Agarwal A. A systematic review on sperm DNA fragmentation in male factor infertility: laboratory assessment. Arab Journal of Urology. 2018; 16(1): 65-76.
22. 22. Sugihara A, Van Avermaete F, Roelant E, Punjabi U, De Neubourg D. The role of sperm DNA fragmentation testing in predicting intra-uterine insemination outcome: A systematic review and meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2020; 244: 8-15.
23. 23. Tvrdá E, Arroyo F, Gosálvez J. Dynamic assessment of human sperm DNA damage I: The effect of seminal plasma-sperm co-incubation after ejaculation. International Urology and Nephrology. 2018; 50(8): 1381-8.
24. 24. Yang H, Li G, Jin H, Guo Y, Sun Y. The effect of sperm DNA fragmentation index on assisted reproductive technology outcomes and its relationship with semen parameters and lifestyle. Translational andrology and urology. 2019; 8(4): 356.
25. 25. Zhang J, Xue H, Qiu F, Zhong J, Su J. Testicular spermatozoon is superior to ejaculated spermatozoon for intracytoplasmic sperm injection to achieve pregnancy in infertile males with high sperm DNA damage. Andrologia. 2019; 51(2): e13175.
26. 26. Zheng W-W, Song G, Wang Q-L, Liu S-W, Zhu X-L, Deng S-M, et al. Sperm DNA damage has a negative effect on early embryonic development following in vitro fertilization. Asian journal of andrology. 2018; 20(1): 75.