DNA fragmentation in brighter sperm predicts male fertility independently from age and semen parameters

Detecting sperm DNA fragmentation by means of TUNEL/PI predicts male fertility status independently from age and semen parameters, providing additional information in routine semen analysis.

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Authors

Monica Muratori, Ph.D., Sara Marchiani, Ph.D., Lara Tamburrino, Ph.D., Marta Cambi, Ph.D., Francesco Lotti, M.D., Ilaria Natali, Ph.D., Erminio Filimberti, Ph.D., Ivo Noci, M.D., Gianni Forti, M.D., Mario Maggi, M.D., Elisabetta Baldi, Ph.D.

Volume 104, Issue 3, Pages 582-590

Abstract

Objective:

To evaluate whether sperm DNA fragmentation (sDF), measured in brighter, dimmer, and total populations, predicts natural conception, and to evaluate the intra-individual variability of sDF.

Design:

Prospective study.

Setting:

Outpatient clinic and diagnostic laboratory.

Patient(s):

A total of 348 unselected patients and 86 proven fertile men.

Intervention(s):

None.

Main Outcome Measure(s):

sDF was revealed with the use of terminal deoxynucleotide transferase–mediated dUTP nick-end labeling (TUNEL)/propidium iodide (PI). Receiver operating characteristic (ROC) curves were built before and after matching fertile men to patients for age (76:152) or semen parameters (68:136) or both (49:98). Intra-individual variability of sDF was assessed over 2 years.

Result(s):

Brighter (area under ROC curve [AUC] 0.718 ± 0.54), dimmer (AUC 0.655 ± 0.63), and total (AUC 0.757 ± 0.54) sDF predict male fertility in unmatched and age- or semen parameters–matched subjects. After matching for both age and semen parameters, only brighter (AUC 0.711 ± 0.83) and total (AUC 0.675 ± 0.92) sDF predict male fertility. At high values of total sDF, brighter predicts natural conception better than total sDF. Intra-individual coefficients of variation of sDF were 9.2 ± 8.6% (n = 25), 12.9 ± 12.7% (n = 53), and 14.0 ± 12.6% (n = 70) over, respectively, 100-day and 1- and 2-year periods, appearing to be the most stable of the evaluated semen parameters.

Conclusion(s):

The predictive power of total sDF partially depends on age and semen parameters, whereas brighter sDF independently predicts natural conception. Therefore, brighter sDF is a fraction of sDF that adds new information to the routine semen analysis. At high levels of sDF, distinguishing the two sperm populations improves the predictive power of sDF. Overall, our results support the idea that TUNEL/PI can be of clinical usefulness in the male fertility workup.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)00427-6/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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