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Volume 19, Issue 1 (January 2017) 19, 80–90; DOI:10.4103/1008-682X.182822
A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome
Luke Simon1, Armand Zini2, Alina Dyachenko2, Antonio Ciampi2, Douglas T Carrell3
1 Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT, USA
2 Division of Urology, Department of Surgery, St. Mary's Hospital Center, St. Mary's Hospital, 3830 Lacombe Avenue, Montreal, Quebec H3T 1M5, Canada
3 Department of Surgery (Urology), University of Utah School of Medicine, Salt Lake City, UT; Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT; Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
Correspondence: Dr. DT Carrell (douglas.carrell@hsc.utah.edu)
Date of Submission 13-Jan-2016 Date of Decision 25-Feb-2016 Date of Acceptance 20-May-2016 Date of Web Publication 24-Jun-2016
| Abstract |
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Sperm DNA damage is prevalent among infertile men and is known to influence natural reproduction. However, the impact of sperm DNA damage on assisted reproduction outcomes remains controversial. Here, we conducted a meta-analysis of studies on sperm DNA damage (assessed by SCSA, TUNEL, SCD, or Comet assay) and clinical pregnancy after IVF and/or ICSI treatment from MEDLINE, EMBASE, and PUBMED database searches for this analysis. We identified 41 articles (with a total of 56 studies) including 16 IVF studies, 24 ICSI studies, and 16 mixed (IVF + ICSI) studies. These studies measured DNA damage (by one of four assays: 23 SCSA, 18 TUNEL, 8 SCD, and 7 Comet) and included a total of 8068 treatment cycles (3734 IVF, 2282 ICSI, and 2052 mixed IVF + ICSI). The combined OR of 1.68 (95% CI: 1.49-1.89; P < 0.0001) indicates that sperm DNA damage affects clinical pregnancy following IVF and/or ICSI treatment. In addition, the combined OR estimates of IVF (16 estimates, OR = 1.65; 95% CI: 1.34-2.04; P < 0.0001), ICSI (24 estimates, OR = 1.31; 95% CI: 1.08-1.59; P = 0.0068), and mixed IVF + ICSI studies (16 estimates, OR = 2.37; 95% CI: 1.89-2.97; P < 0.0001) were also statistically significant. There is sufficient evidence in the existing literature suggesting that sperm DNA damage has a negative effect on clinical pregnancy following IVF and/or ICSI treatment.
Keywords: assisted reproductive technology outcomes; clinical pregnancy; meta-analysis; sperm DNA damage; systematic review
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