ABSTRACT
To evaluate the degree of DNA fragmentation in human sperm used for ICSI to determine the effect of sperm DNA fragmentation on fertilization rate, embryo cleavage rate, embryo quality and biochemical pregnancy rates after ICSI. Design: Prospective, analytic descriptive study. Settings: Tertiary care fertility clinic. Patient[s]: Fifty couples undergoing ICSI treatment due to male factor infertility. Intervention[s]: The percentage of spermatozoa with DNA fragmentation was determined using the method f terminal deoxynucleotidyl transferase mediated UTP- biotin end- labeling [TUNEL] Main Outcome Measure[s]: The percentage of spermatozoa with DNA fragmentation was correlated with semen analysis parameters, ICSI fertilization rate, embryo cleavage rate, embryo grades and biochemical pregnancy rate. Result[s]: The mean [ +/- SD] percentage of spermatozoa with DNA fragmentation was 30.2 +/- 13.8%. A significant negative correlation was found between the percentage of sperm with DNA fragmentation and the concentration and motility of the ejaculated sperm. In addition, a significant negative association was found between the percentage of sperm with DNA fragmentation and fertilization rate, embryo cleavage rate, embryo quality and biochemical pregnancy rate. Conclusion[s]: Detection of DNA fragmentation in human sperm could provide additional information about the biochemical integrity of sperm and may explain fertilization failure after ICSI. By learning more about the fundamental mechanisms that cause sperm DNA fragmentation, it should be possible to develop more precise tests to describe defects and then to develop new therapeutic modalities designed to overcome these specific defects