THE ASSOCIATION OF SPERM DNA FRAGMENTATION WITH EMBRYOLOGICAL CHARACTERISTICS AND EFFECTIVENESS OF ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS

Objective. To determine the relationship between sperm DNA integrity in the ejaculate, embryological parameters (oocyte fertilization rate; blastulation rate), clinical outcomes of assisted reproductive technology programs, and methods for sperm selection by hyaluronic acid binding. Subjects and methods. 67 married couples with a high rate of DNA fragmentation in the ejaculate of sexual partners, who had been treated using the in vitro fertilization/intracytoplasmic sperm injection ((IVF/ICSI) and IVF/physiological intracytoplasmic sperm injection (PICSI) programs, were examined during the prospective case-control study. The couples were divided into 2 groups according to the type of fertilization (ICSI, PICSI): 1) 37 couples who had ICSI; 2) 30 couples who had PICSI. The investigators estimated the rate of sperm DNA fragmentation in the partner’s ejaculate and embryological parameters (oocyte fertilization rate; blastulation rate), and clinical outcomes of the IVF/ICSI programs with various methods for sperm selection. The embryological parameters (oocyte fertilization rate; blastulation rate), clinical outcomes in the IVF/ICSI programs with various methods for sperm selection were also assessed. Results. Our investigation showed that both groups had no statistically significant differences in the rates of oocyte fertilization and blastulation and in the number of early reproductive losses, which may be associated with a small sample size in the groups. However, there was an obvious trend toward an increase in clinical pregnancy rates in the group where sperm was selected by hyaluronate binding before an ICSI procedure. In addition, there were significant differences in live birth rates in favor of using the methods for the physiological selection of male gametes. According to our data, there are also significant differences in implantation rates between the ICSI and PICSI groups, demonstrating the direct relationship of the quality of embryos to the genetic adequacy of the gametes. Conclusion. The choice of a fertilization technique for oocytes from a patient should be individualized. Determination of the rate of DNA fragmented sperm from a partner can serve as an additional test used in clinical practice to optimize the choice of methods for fertilization of oocytes from a female patient according to the type of sperm selection and to improve the efficiency of IVF programs as a whole.

in vitro fertilization, infertility, hyaluronic acid, sperm selection, intracytoplasmic sperm injection, physiological intracytoplasmic sperm injection, assisted reproductive technologies