Sperm chromatin structure assay high DNA stainability sperm as a marker of early miscarriage after intracytoplasmic sperm injection

Research output: Contribution to journalArticle


Objective: To determine whether high DNA stainability (HDS), as assessed by the sperm chromatin structure assay (SCSA), predicts the risk of early miscarriage after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI). Design: Retrospective cohort study of consecutive pregnancies after IVF and ICSI treatment. Setting: Reproductive medicine center. Patient(s): A total of 1,602 pregnancies after 832 IVF and 770 ICSI treatments. Intervention(s): HDS measured using SCSA. Main Outcome Measure(s): Early miscarriage (≤12 weeks). Result(s): The HDS represents the proportion of immature spermatozoa lacking the normal exchange of histone for protamine-complexed DNA, and the outcome parameter was early miscarriage (≤12 weeks). For all treatments, the odds ratio (OR)and 95% confidence interval (CI)for early miscarriage was 1.41 (1.07–1.85)if HDS >15% compared with HDS ≤15%. When comparing the two HDS categories, for ICSI, the OR was 1.44 (1.01–2.04)whereas for IVF the results were not statistically significant. Conclusion(s): There is a small but increased risk of early miscarriage if HDS >15% compared with HDS ≤15%. This increased risk is seen only after ICSI, not after IVF. These findings suggest that HDS can be used as a predictor of an increased risk of miscarriage in ICSI treatments.


External organisations
  • Lund University
  • SCSA Diagnostics, Inc.
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Obstetrics, Gynecology and Reproductive Medicine


  • DNA fragmentation, early miscarriage rate, high DNA stainability, in vitro fertilization, sperm DNA integrity
Original languageEnglish
JournalFertility and Sterility
Publication statusE-pub ahead of print - 2019 Apr 28
Publication categoryResearch