Sperm Chromatin Abnormalities and DNA Damage Predict Assisted Reproductive Outcome

This study aimed to evaluate the effect of sperm chromatin quality and DNA fragmentation of spermatozoa on assisted conception outcomes. Patients with male factor infertility (MFI) were grouped into normozoospermic (N), severe male factor (SMF), and mild male factor (MMF) infertility. DNA fragmentation index (DFI) in spermatozoa was analyzed by sperms chromatin dispersion (SCD), sperm chromatin structure assay (SCSA), Acridine Orange testing (AOT), chromatin maturation (CM) including CMA3 to measure protamination and Toluidine Blue (TB) to measure chromatin condensation. DFI measured by SCD, SCSA, and AOT while CM checked through protamination chromomycin A3 (CMA3) and chromatin condensation TB, were significantly lower in N compared with infertile groups (MMF and SMF). Embryo aneuploidy was significantly higher in male factor infertile groups (MMF and SMF) compared to N. A positive correlation was observed between fertilization rate (FR) and live birth rate (LBR) with sperm count, motility, vitality, and negative correlation between sperm morphology, sperm DFI, (SCD, SCSA, and AO) sperm CMI (CMA3 and TB). No correlation was observed between embryo aneuploidy and sperm DFI and CMI. Spermatozoa DFI and CMI are associated with low fertilization and live birth rate. The couples undergoing invitro-fertilization (IVF) or intracytoplasmic injection (ICSI) with male factor infertility; including impaired semen parameters, sperm DNA and chromatin quality could be regarded in the future as an indication and prediction of assisted reproduction techniques (ART), its success.