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

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T1 - Sperm chromatin structure assay high DNA stainability sperm as a marker of early miscarriage after intracytoplasmic sperm injection

AU - Jerre, Elsa

AU - Bungum, Mona

AU - Evenson, Donald

AU - Giwercman, Aleksander

PY - 2019/4/28

Y1 - 2019/4/28

N2 - 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.

AB - 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.

KW - DNA fragmentation

KW - early miscarriage rate

KW - high DNA stainability

KW - in vitro fertilization

KW - sperm DNA integrity

U2 - 10.1016/j.fertnstert.2019.03.013

DO - 10.1016/j.fertnstert.2019.03.013

M3 - Article

JO - Fertility and Sterility

T2 - Fertility and Sterility

JF - Fertility and Sterility

SN - 1556-5653

ER -