Effect of sperm DNA fragmentation on the clinical outcomes of two assisted reproduction methods: IVF and ICSI

Objective: To investigate the effect of sperm DNA fragmentation index (DFI) on the clinical outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods: Infertile couples were prospectively recruited in the Reproductive Center in Jiaozuo Maternal and Child Care Service Centre in Henan, China, from July 2015 to December 2016. All the recruited 228 infertile couples were divided into IVF group (135 cycles) and ICSI group (100 cycles) in accordance with what kinds of assisted reproductive technology (ART) they had chosen. Firstly, DFI of males in the two groups were detected by sperm chromatin structure analysis (SCSA). Then, the semen samples were collected on the day of oocyte retrieval of female spouses and performed the routine semen analysis and DFI testing. Finally, according to DIF level, the two group patients were divided into three groups: Group A (DFI<8%), Group B (8%≤DFI<15%), Group C (15%≤DFI<25%). The rates of fertilization, embryo cleavage, good quality embryos, embryos implantation and clinical pregnancy in VFI and ICSI cycles were analyzed and compared among three groups. Results: During the normal treatment cycle, when DFI≤15%, there was no statistical difference between IVF and ICSI in the rates of fertilization, embryo cleavage, good quality embryos, embryos implantation and clinical pregnancy (P>0.05). When 15%≤DFI<25%, the rates of fertilization and clinical pregnancy rates in ICSI were significantly higher than those in IVF (P<0.05), but there was also no significant difference between IVF and ICSI in good quality embryos rate (P>0.05). Conclusion: The rise of DFI level can not only reduce the sperm motility but also affect the clinical outcomes of IVF and ICSI. While the outcomes of IVF and ICSI are statistically similar when DFI level is less than 15%, the curative effect of ICSI is better when DFI value exceeds 15%.