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Volume 15, Issue 6 (November 2013) 15, 812–818; 10.1038/aja.2013.74

Can DNA fragmentation of neat or swim-up spermatozoa be used to predict pregnancy following ICSI of fertile oocyte donors?

Jaime Gosálvez1, Pedro Caballero2, Carmen López-Fernández1, Leonor Ortega2, José Andrés Guijarro2, José Luís Fernández3, Stephen D Johnston4 and Rocío Nuñez-Calonge2

1Faculty of Biology, Autonomous University of Madrid, Cantoblanco, Madrid 28049, Spain
2Clínica Tambre, Madrid 28002, Spain
3GINIBIC-Complejo Hospitalario Universitario, A Coruña, A Coruña15006, Spain
4School of Agriculture and Food Science, The University of Queensland, Gatton 4343, Australia

Correspondence: Professor J Gosálvez, (jaime.gosalvez@uam.es)

Received 11 February 2013; Revised 12 March 2013; Accepted 13 May 2013 Advance online publication 14 October 2013


This study compared the potential of assessing sperm DNA fragmentation (SDF) from neat semen and the subsequent swim-up (SU) procedure to predict pregnancy when conducting ICSI of fertile donor oocytes. Infertile females (n=81) were transferred embryos resulting from intracytoplasmic sperm injection (ICSI) of their partner's spermatozoa and proven donor oocytes. This model normalized the impact of female factor in putative sperm DNA repair. Semen was blindly assessed for SDF using Halosperm immediately following ejaculation (NS) and after swim-up at the time of ICSI fertilisation. There was a decrease in SDF values of the ejaculated semen sample following the swim-up protocol (P=0.000). Interestingly, pregnancy could be equally predicted from SDF values derived from either neat or swim-up semen samples. Receiver operator curves and the derived Youden's indices determined SDF cutoff values for NS and SU of 24.8% and 17.5%, respectively. Prediction of pregnancy from NS SDF had a sensitivity of 75% and a specificity of 69%, whereas for SU SDF was 78% and 73%, respectively. While increased levels of SDF negatively impact reproductive outcome, we have shown that a reduction in SDF following sperm selection using ICSI with proven donor oocytes is not mandatory for achieving pregnancy. This suggests that a certain level of DNA damage that is not detectable using current technologies could be impacting on the relative success of assisted reproductive technology (ART) procedures. Consequently, we propose a modification of the so called ‘iceberg model' as a possible rationale for understanding the role of SDF in reproductive outcome.

Keywords: assisted reproductive technology; egg donation; male factor; sperm DNA fragmentation

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