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Volume 24, Issue 1 (January 2022) 24, 40–44; 10.4103/aja.aja_49_21

Evaluation of the sperm DNA fragmentation index in infertile Japanese men by in-house flow cytometric analysis

Akiyoshi Osaka1, Hiroshi Okada2, Sae Onozuka2, Takashi Tanaka2, Toshiyuki Iwahata2, Yukihito Shimomura2, Yoshitomo Kobori1, Kazutaka Saito1, Kouhei Sugimoto2

1 Department of Urology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 343-8555, Japan
2 International Center for Reproductive Medicine, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 343-8555, Japan

Correspondence: Dr. H Okada (hirooka@dokkyomed.ac.jp)

Date of Submission 03-Oct-2020 Date of Acceptance 12-Apr-2021 Date of Web Publication 08-Jun-2021


Semen analysis has long been used to evaluate male fertility. Recently, several sperm function tests have been developed. Of those, the sperm DNA fragmentation index (DFI), which describes the status of the sperm DNA, is thought to be a suitable parameter for evaluating male fertility. However, there have been no large-scale studies on the sperm DFI of Japanese men. Therefore, we investigated the feasibility of using an in-house flow cytometry-based sperm DFI analysis based on the sperm DNA fragmentation test of sperm chromatin structure assay (SCSA) to assess male fertility in Japan. This study enrolled 743 infertile and 20 fertile Japanese men. To evaluate reproducibility, inter- and intraobserver precision was analyzed. A receiver operating characteristic curve analysis was used to set a cutoff value for the sperm DFI to identify men who could father children by timed intercourse or intrauterine insemination. The variability of the sperm DFI among fertile volunteers was determined. The relationship between semen parameters and the sperm DFI was assessed by Spearman's rho test. A precision analysis revealed good reproducibility of the sperm DFI. The cutoff value of sperm DNA fragmentation in infertile men was 24.0%. Semen volume had no relationship with the sperm DFI. Sperm concentration, sperm motility, total motile sperm count, and percentage of normal-shaped sperm were significantly and negatively correlated with the sperm DFI. The median sperm DFI was smaller in fertile volunteers (7.7%) than that in infertile men (19.4%). Sperm DNA fragmentation analysis can be used to assess sperm functions that cannot be evaluated by ordinary semen analysis.

Keywords: DNA fragmentation; flow cytometry; male infertility; semen analysis; spermatozoa

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