| 1. |
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| 2. |
- Bungum, Leif, et al.
(författare)
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The circadian variation in anti-müllerian hormone in patients with polycystic ovary syndrome differs significantly from normally ovulating women.
- 2013
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:9
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Tidskriftsartikel (refereegranskat)abstract
- To improve the biologic understanding of the Polycystic Ovarian Syndrome (PCOS) condition by examining the circadian variation and relationship between Anti Müllerian Hormone (AMH), gonadotropins and ovarian steroids in PCOS patients compared to normally ovulating and menstruating women. By comparing the pattern of co-variation between AMH and Luteinizing Hormone, two compounds closely linked to hyperandrogenism and anovulation in PCOS, the involvement of the Hypothalamic-Pituitary-Ovarian axis in PCOS pathology could be elucidated.
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| 3. |
- Bungum, Mona, et al.
(författare)
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A prospective study, using sibling oocytes, examining the effect of 30 seconds versus 90 minutes gamete co-incubation in IVF.
- 2006
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 21:2, s. 518-523
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Traditionally oocytes have been exposed to sperm overnight, for 16-20 h. This long period of co-incubation, however, has been shown to create problems with high levels of reactive oxygen species (ROS), which may affect embryo viability and cause hardening of the zona pellucida. Recently, a positive effect of reducing the co-incubation time to 90-120 min was reported. The objective of this study was to evaluate whether a further reduction of the co-incubation period could benefit the outcome of IVF. METHODS: In this prospective study, 777 sibling oocytes from 81 women undergoing IVF were divided via alternate allocation to co-incubation for either 30 s (ultrashort co-incubation) (group A) or for 90 min (standard co-incubation) (group B). Endpoints were normal fertilization (two-pronuclear, 2PN), polyspermy (> 2PN), embryo quality (EQ), clinical pregnancy (CP) and implantation (IR). RESULTS: The normal fertilization rates of the two groups were comparable: group A 58.6% versus group B 58.0%. Significantly lower rates of polyspermy were seen in group A compared to group B (2.8 versus 7.2%, P = 0.008). No statistically significant differences in EQ, CP or IR were seen. CONCLUSION: This is the first study demonstrating the achievement of good fertilization rates in IVF with ultrashort co-incubation. Significantly lower rates of polyspermy were seen in the group with ultrashort compared to the standard co-incubation group. Further studies are, however, needed in order to evaluate whether ultrashort co-incubation has any effect on the outcome of IVF.
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| 4. |
- Bungum, Mona, et al.
(författare)
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Polymorphisms in the protein C inhibitor gene in in vitro fertilization failure.
- 2010
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 1556-5653 .- 0015-0282. ; 93:1, s. 277-279
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to determine whether total fertilization failure in human IVF can be partially explained by alterations in the gene that codes for protein C inhibitor. Forty-six men had IVF total fertilization failure and 51 controls with normal fertilization were screened for mutations in the protein C inhibitor gene by direct sequencing. The main finding was that in men involved in total fertilization failure, a heterozygous adenosine/guanine (A/G) base combination in position 1389 (rs2069990) (exon 6) in the protein C inhibitor gene was significantly more common compared with controls (10.9% vs. 0).
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| 5. |
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| 6. |
- Bungum, Mona, et al.
(författare)
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Sperm chromatin structure assay (SCSA): a tool in diagnosis and treatment of infertility
- 2011
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Ingår i: Asian Journal of Andrology. - : Medknow. - 1008-682X .- 1745-7262. ; 13:1, s. 69-75
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Forskningsöversikt (refereegranskat)abstract
- Diagnosis of male infertility has mainly been based on the World Health Organization (WHO) manual-based semen parameter's concentration, motility and morphology. It has, however, become apparent that none of these parameters are reliable markers for evaluation of the fertility potential of a couple. A search for better markers has led to an increased focus on sperm chromatin integrity testing in fertility work-up and assisted reproductive techniques. During the last couple of decades, numerous sperm DNA integrity tests have been developed. These are claimed to be characterized by a lower intraindividual variation, less intralaboratory and interlaboratory variation and thus less subjective than the conventional sperm analysis. However, not all the sperm chromatin integrity tests have yet been shown to be of clinical value. So far, the test that has been found to have the most stable clinical threshold values in relation to fertility is the sperm chromatin structure assay (SCSA), a flow cytometric test that measures the susceptibility of sperm DNA to acid-induced DNA denaturation in situ. Sperm DNA fragmentation as measured by SCSA has shown to be an independent predictor of successful pregnancy in first pregnancy planners as well as in couples undergoing intrauterine insemination, and can be used as a tool in investigation, counseling and treatment of involuntary childlessness. More conflicting data exist regarding the role of sperm DNA fragmentation in relation to fertilization, pre-embryo development and pregnancy outcome in in vitro fertilization and intracytoplasmic sperm injection (ICSI). Asian Journal of Andrology (2011) 13, 69-75; doi: 10.1038/aja.2010.73; published online 8 November 2010
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| 7. |
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| 8. |
- Bungum, Mona, et al.
(författare)
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Spermatozoa DNA damage measured by sperm chromatin structure assay (SCSA) and birth characteristics in children conceived by IVF and ICSI.
- 2012
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Ingår i: International Journal of Andrology. - : Wiley. - 1365-2605 .- 0105-6263. ; 35:4, s. 485-490
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Tidskriftsartikel (refereegranskat)abstract
- High levels of spermatozoa DNA damage hinder fertility in vivo but not in vitro. It is a source of worry that following in vitro fertilization (IVF) spermatozoa DNA damage, if not repaired by the oocyte, might have a negative impact on the offspring. The aim of this study was to assess if a high spermatozoa DNA Fragmentation Index (DFI) is associated with alterations in birthweight (BW) and/or gestational length in IVF children. One hundred and thirty-one singleton pregnancies established by standard IVF or intracytoplasmic sperm injection (ICSI) were included in the study. DFI was measured by sperm chromatin structure assay (SCSA) in semen samples used for fertilization. DFI was categorized as low and high, using 20, 30, 40 and 50% as cut-off levels. Birthweight, gestational age, as well as gestational age adjusted BW score were used in a linear regression model as end points For none of the tested birth characteristics, statistically significant differences between the groups with low and high DFI were seen regardless of whether 20, 30, 40 or 50% were used as cut-off levels, both when the IVF and ICSI data were merged or analysed separately. Spermatozoa DNA damage as assessed by SCSA is not associated with BW or gestational length in IVF and ICSI children.
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| 9. |
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| 10. |
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| 11. |
- Thomsen, Lise, et al.
(författare)
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The impact of male overweight on semen quality and outcome of assisted reproduction
- 2014
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Ingår i: Asian Journal of Andrology. - 1008-682X. ; 16:5, s. 749-754
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Tidskriftsartikel (refereegranskat)abstract
- It is well-documented that male overweight and obesity causes endocrine disorders that might diminish the male reproductive capacity; however, reports have been conflicting regarding the influence of male body mass index (BMI) on semen quality and the outcome of assisted reproductive technology (ART). The aim of this study was to investigate whether increased male BMI affects sperm quality and the outcome of assisted reproduction in couples with an overweight or obese man and a non-obese partner. Data was prospectively collected from 612 infertile couples undergoing ART at a Danish fertility center. Self-reported information on paternal height and weight were recorded and BMI was calculated. The men were divided into four BMI categories: underweight BMI < 20 kg m(2) , normal BMI 20-24.9 kg m(2) , overweight BMI 25-29.9 kg m(2) and obese BMI > 30 kg m(2) . Conventional semen analysis was performed according to the World Health Organization guideline and sperm DNA integrity was analyzed by the Sperm Chromatin Structure Assay (SCSA). No statistically significant effect of male BMI was seen on conventional semen parameters (sperm concentration, total sperm count, seminal volume and motility) or on SCSA-results. Furthermore, the outcome of ART regarding fertilization rate, number of good quality embryos (GQE ), implantation and pregnancy outcome was not influenced by the increasing male BMI.
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| 12. |
- Andersen, Jorunn M, et al.
(författare)
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Body Mass Index Is Associated with Impaired Semen Characteristics and Reduced Levels of Anti-Müllerian Hormone across a Wide Weight Range.
- 2015
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:6
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Tidskriftsartikel (refereegranskat)abstract
- There is still controversy as to how body mass index (BMI) affects male reproduction. We investigated how BMI is associated with semen quality and reproductive hormones in 166 men, including 38 severely obese men. Standard semen analysis and sperm DNA integrity analysis were performed, and blood samples were analysed for reproductive hormones. Adjusted for age and time of abstinence, BMI was negatively associated with sperm concentration (B = -0.088, P = 0.009), total sperm count (B = -0.223, P = 0.001), progressive sperm motility (B = -0.675, P = 0.007), normal sperm morphology (B = -0.078, P = 0.001), and percentage of vital spermatozoa (B = -0.006, P = 0.027). A negative relationship was observed between BMI and total testosterone (B = -0.378, P < 0.001), sex hormone binding globulin (B = -0.572, P < 0.001), inhibin B (B = -3.120, P < 0.001) and anti-Müllerian hormone (AMH) (B = -0.009, P < 0.001). Our findings suggest that high BMI is negatively associated with semen characteristics and serum levels of AMH.
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| 13. |
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| 14. |
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| 15. |
- Bungum, Mona, et al.
(författare)
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Sperm chromatin structure assay parameters measured after density gradient centrifugation are not predictive for the outcome of ART
- 2008
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 23:1, s. 41374-41374
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND The sperm chromatin structure assay (SCSA) parameter DNA fragmentation index (DFI) has been shown to predict in vivo and in vitro fertility. So far most SCSA studies have been based on SCSA analysis performed on neat semen. The aim of this study is to assess whether SCSA analysis of sperm prepared by density gradient centrifugation (DGC) could add more information in regard to the prediction of treatment outcome. METHODS The study included 510 assisted reproductive technique (ART) cycles. SCSA was performed in neat semen and post DGC. SCSA results were expressed in terms of DFI and high DNA stainability (HDS) cell fractions. The outcome parameter was clinical pregnancy (CP). RESULTS Scatter-plot diagrams demonstrated that for DGC samples, no DFI cut-off values could be set for in vivo or in vitro fertility. In intrauterine insemination, IVF and ICSI groups the mean difference (95% CI) in DFI post DGC between those who achieved CP and those who did not was 0.2% (-1.7 to 2.0%), 0.4% (-1.9 to 2.8%) and 1.3% (-3.1 to 5.9%), respectively, none of these being statistically significant. The corresponding differences for HDS were 0.1% (-1.3 to 1.5%), 0.1% (-0.7 to 0.9%) and 0.6% (-1.6 to 2.7%), respectively (all P-values >0.6). CONCLUSIONS SCSA performed in semen prepared by DGC cannot predict the outcome of ART.
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| 16. |
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| 17. |
- Bungum, Mona
(författare)
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Sperm DNA integrity assessment: a new tool in diagnosis and treatment of fertility.
- 2012
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Ingår i: Obstetrics and Gynecology International. - : Hindawi Limited. - 1687-9589 .- 1687-9597. ; 2012
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Tidskriftsartikel (refereegranskat)abstract
- Infertility affects 15% of all couples. Although male infertility factors with reduced semen quality are contributing to about half of all involuntary childlessness, the value of standard semen parameters in prediction of fertility in vivo and choice of proper method for assisted reproduction is limited. In the search for better markers of male fertility, during the last 10 years, assessment of sperm DNA integrity has emerged as a strong new biomarker of semen quality that may have the potential to discriminate between infertile and fertile men. Sperm DNA Fragmentation Index (DFI) as assessed by the flow cytometric Sperm Chromatin Structure Assay (SCSA) can be used for evaluation of sperm chromatin integrity. The biological background for abnormal DFI is not completely known, but clinical data show that DFI above 30% is associated with very low chance for achieving pregnancy in natural way or by insemination, but not in vitro. Already when the DFI is above 20%, the chance of natural pregnancy may be reduced, despite other sperm parameters being normal. Thus this method may explain a significant proportion of cases of unexplained infertility and can be beneficial in counselling involuntary childless couples need of in vitro fertilisation.
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| 18. |
- Bungum, Mona
(författare)
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Studies on genetic aberrations as possible predictors of the outcome of assisted reproduction
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Traditionally, diagnosis of male infertility has relied upon microscopic assessment of semen. The normality criteria set by the World Health Organization (WHO) in regard to sperm concentration, motility and morphology are, however, poor predictors of fertility. In about half of the involuntarily childless couples the causes are solely or partly male related. In 60-75% of cases the aetiology of reduced semen quality remains unexplained and is referred to as being idiopathic. In recent years fragmentation of sperm DNA and/or genetic polymorphisms have attracted an increased interest in seeking for causes of male mediated infertility. However, when the work behind this thesis was initiated, the knowledge regarding the impact of somatic and germ cells genetic aberrations, in relation to in vivo and in vitro fertility, was rather limited. Many of the involuntarily childless couples seek for assisted reproduction (ART), however, the “baby-take-home rates” in ART are still relatively low. One of the reasons for this is a lack of adequate methods to evaluate the fertility potential of a couple and also a lack of methods to identify the most effective type of ART treatment for a given couple. Thus, the overall aim of these studies was to identify genetic markers with a potential to predict the chance of success or failure of ART. The present studies demonstrated that DNA fragmentation index (DFI), as measured by the sperm chromatin structure assay (SCSA), can be used as an independent predictor of fertility in couples undergoing intrauterine insemination (IUI). If DFI is above 30% the chance of pregnancy by IUI is close to zero and intracytoplasmic sperm injection (ICSI) is more effective than classical in vitro fertilisation (IVF).DFI was predictive of the outcome of ART only when measured in neat semen, not in density gradient centrifuged. Moreover, the present studies have shown that, like the other sperm parameters, DFI is subject to a significant intra-individual variation, with a coefficient of variation of 29%. Finally, it was found that in men from couples experiencing IVF fertilisation failure a specific polymorphism in the Protein C Inhibitor (PCI) gene is significantly more common compared to cases with normal fertilisation rates after IVF. The results indicate that in a subgroup of cases total fertilisation failure may be caused by polymorphisms in the PCI gene. In conclusion the present studies have demonstrated that both somatic and sperm genetic aberrations can be used as markers of the outcome of ART.
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| 19. |
- Erenpreiss, Juris, et al.
(författare)
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Intra-individual variation in sperm chromatin structure assay parameters in men from infertile couples: clinical implications.
- 2006
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 21:2006 May 9, s. 2061-2064
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sperm DNA integrity is an important factor in the prognosis of male fertility. In this study, we investigated intra-individual variation of sperm chromatin structure assay (SCSA) parameters in infertility patients undergoing assisted reproductive techniques (ARTs). METHODS: Retrospective study of 282 consecutive patients referred for ART [intrauterine insemination (IUI), IVF or ICSI] with repeated (between 2 and 5) SCSA measurements. RESULTS: Mean coefficient of variation (CV) of DNA Fragmentation Index (DFI) for repeated SCSA measurements was 29%. A high proportion [37%; 95% confidence interval (CI): 27%, 49%] of patients with DFI > 30% in the first test had DFI < 30% in the second test. Also, a considerable proportion (27%; 95% CI : 16%, 40%) of patients with 21-30% DFI values in the first test had DFI > 30% in the second test. CONCLUSIONS: Intra-individual variability in DFI is significant, therefore repeated SCSA measurements are recommended. The biological mechanisms behind these variations remain to be elucidated.
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| 20. |
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| 21. |
- Giwercman, Aleksander, et al.
(författare)
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Sperm chromatin structure assay as an independent predictor of fertility in vivo: a case-control study.
- 2010
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Ingår i: International Journal of Andrology. - : Wiley. - 1365-2605 .- 0105-6263. ; 33, s. 221-227
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Tidskriftsartikel (refereegranskat)abstract
- Summary Standard sperm parameters have a limited power for prediction of the chance of natural conception. Recent studies have indicated that the sperm chromatin structure assay (SCSA) DNA fragmentation index (DFI), a measure for the fraction of sperms with DNA damage, is associated with fertility in vivo. The aim of this study was to evaluate the value of this parameter for prediction of infertility. One hundred and twenty-seven men from infertile couples with no known female factor and 137 men with proven fertility were included. Semen analysis was performed as recommended by the WHO. DFI was assessed using SCSA. Logistic binary regression was used to compute the odds ratios (OR) for infertility. As compared with men with a DFI <10%, men with a DFI between 10% and 20% had an increased risk for infertility (OR 2.5, 95% CI: 1.0-6.1). This was also true for men with a DFI >20% (OR 8.4; 95% CI: 3.0-23). In men with normal standard semen parameters (sperm concentration, motility and morphology) the OR for infertility was increased with DFI >20% (OR 5.1, 95% CI: 1.2-23), whereas if one of the standard semen parameters was abnormal, the OR for infertility was increased already at DFI above 10% (OR 16, 95% CI: 4.2-60). We conclude that SCSA DFI adds to the value of semen analysis in prediction of the chance of natural conception.
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| 22. |
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| 23. |
- Jerre, Elsa, et al.
(författare)
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Sperm chromatin structure assay high DNA stainability sperm as a marker of early miscarriage after intracytoplasmic sperm injection
- 2019
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282. ; 112:1, s. 2-53
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine whether high DNA stainability (HDS), as assessed by the sperm chromatin structure assay (SCSA), predicts the risk of early miscarriage after in vitro fertilization with intracytoplasmic sperm injection (IVF-ICSI). Design: Retrospective cohort study of consecutive pregnancies after IVF and ICSI treatment. Setting: Reproductive medicine center. Patient(s): A total of 1,602 pregnancies after 832 IVF and 770 ICSI treatments. Intervention(s): HDS measured using SCSA. Main Outcome Measure(s): Early miscarriage (≤12 weeks). Result(s): The HDS represents the proportion of immature spermatozoa lacking the normal exchange of histone for protamine-complexed DNA, and the outcome parameter was early miscarriage (≤12 weeks). For all treatments, the odds ratio (OR)and 95% confidence interval (CI)for early miscarriage was 1.41 (1.07–1.85)if HDS >15% compared with HDS ≤15%. When comparing the two HDS categories, for ICSI, the OR was 1.44 (1.01–2.04)whereas for IVF the results were not statistically significant. Conclusion(s): There is a small but increased risk of early miscarriage if HDS >15% compared with HDS ≤15%. This increased risk is seen only after ICSI, not after IVF. These findings suggest that HDS can be used as a predictor of an increased risk of miscarriage in ICSI treatments.
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| 24. |
- Kaspersen, M. D., et al.
(författare)
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No increased sperm DNA fragmentation index in semen containing human papillomavirus or herpesvirus
- 2013
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Ingår i: Andrology. - : Wiley. - 2047-2927 .- 2047-2919. ; 1:3, s. 361-364
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Tidskriftsartikel (refereegranskat)abstract
- It remains unknown whether human papillomaviruses (HPVs) or human herpesviruses (HHVs) in semen affect sperm DNA integrity. We investigated whether the presence of these viruses in semen was associated with an elevated sperm DNA fragmentation index. Semen from 76 sperm donors was examined by a PCR-based hybridization array that identifies all HHVs and 35 of the most common HPVs. Sperm DNA integrity was determined by the sperm chromatin structure assay. HPVs or HHVs, or both, were found in 57% of semen samples; however, sperm DNA fragmentation index was not increased in semen containing these viruses.
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| 25. |
- Oleszczuk, Krzysztof, et al.
(författare)
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Intra-individual variation of the sperm chromatin structure assay DNA fragmentation index in men from infertile couples.
- 2011
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 26:12, s. 3244-3248
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThe sperm chromatin structure assay (SCSA) is a valuable tool for prediction of fertility in vivo, with DNA fragmentation index (DFI) of 30% as a clinically useful cut-off level. Previous studies on fertile men have shown a high level of repeatability, with an intra-individual variability in DFI of ∼10%. However, conflicting data on how much the DFI fluctuates within individuals exist. The aim of the present study was to investigate the intra-individual variation of DFI in order to further evaluate the clinical use of SCSA.METHODSAmong 2409 consecutive men under infertility investigation, repeated SCSA analyses were performed on 616 samples from men between 18 and 66 years of age. The coefficient of variation (CV) for DFI was calculated. For each patient, we also analyzed whether the DFI value in tests I and II switched the category from <30 to >30%, or vice versa.RESULTSMean CV for DFI for men with at least two SCSA analyses within a 30-month period was 30.1% (SD 21.5). Compared with the first test, 85% (95% confidence interval: 82-87%) of the men remained on the same side of the cut-off point of 30%.CONCLUSIONSDespite showing a high intra-individual CV for DFI, 85% of the men from infertile couples did not change category between tests, with respect to the cut-off level of 30%. Thus, using the previously established DFI cut-off value of 30%, a single SCSA analysis has a high predictive value for assessing fertility in vivo.
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| 26. |
- Oleszczuk, Krzysztof, et al.
(författare)
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Prevalence of high DNA fragmentation index in male partners of unexplained infertile couples.
- 2013
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Ingår i: Andrology. - : Wiley. - 2047-2927 .- 2047-2919. ; 1:3, s. 357-360
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Tidskriftsartikel (refereegranskat)abstract
- The sperm chromatin structure assay (SCSA) parameter DNA fragmentation Index (DFI) is a valuable tool for prediction of fertility in vivo. Clinical data show that a DFI above 30% is associated with very low chance for achieving pregnancy by natural conception or by insemination. Already when DFI is above 20% the chance of natural pregnancy is reduced, this despite normal conventional semen parameters. The aim of the present study was to investigate the prevalence of high DFI in male partners of unexplained infertile couples to further identification of male factors contributing to subfertility. Among 212 consecutive men under infertility investigation, 122 cases with the diagnosis 'unexplained infertility' were identified. For all but three, SCSA data were available. The percentage of couples with diagnosis 'unexplained infertility' in which the male partner has DFI >20% or DFI >30% was calculated. In the group diagnosed with 'unexplained infertility' 17.7% of the men (95% CI 10.8-24.5) presented with 20 ≤DFI <30 and 8.4% (95% CI 3.40-13.4) had DFI ≥30%. A significant part of men diagnosed as unexplained infertile according to traditional diagnostic methods has remarkably high degrees of fragmented sperm DNA. Apart from adding to our understanding of biology of infertility our finding has clinical implications. Couples in which the DFI of the male partner is high can avoid prolonged attempts to become spontaneously pregnant or referral for intrauterine insemination, both having low chances of leading to conception.
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| 27. |
- Oleszczuk, Krzysztof, et al.
(författare)
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Sperm chromatin structure assay in prediction of in vitro fertilization outcome.
- 2016
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Ingår i: Andrology. - : Wiley. - 2047-2927 .- 2047-2919. ; 4:2, s. 290-296
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Tidskriftsartikel (refereegranskat)abstract
- Sperm DNA fragmentation index (DFI) assessed by sperm chromatin structure assay is a valuable tool for prediction of fertility in vivo. Previous studies on DFI as predictor of in vitro fertilization (IVF) outcome, based on relatively small materials, gave contradictory results. The present study examines, in a large cohort, the association between sperm DFI and the outcome of IVF/ICSI procedure. The study is based on 1633 IVF or ICSI cycles performed at the Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden, between May 2007 and March 2013. DFI values were categorized into four intervals: DFI ≤ 10% (reference group), 10% < DFI ≤ 20%, 20% < DFI ≤ 30%, DFI > 30%. For the three latter intervals, the following outcomes of IVF/ICSI procedures were analyzed in relation to the reference group: fertilization, good quality embryo, pregnancy, miscarriage, and live births. In the standard IVF group, a significant negative association between DFI and fertilization rate was found. When calculated per ovum pick-up (OPU) Odds Ratios (ORs) for at least one good quality embryo (GQE) were significantly lower in the standard IVF group if DFI > 20%. OR for live birth calculated per OPU was significantly lower in standard IVF group if DFI > 20% (OR 0.61; 95% CI: 0.38-0.97; p = 0.04). No such associations were seen in the ICSI group. OR for live birth by ICSI compared to IVF were statistically significantly higher for DFI > 20% (OR 1.7; 95% CI: 1.0-2.9; p = 0.05). OR for miscarriage was significantly increased for DFI > 40% (OR 3.8; 95% CI: 1.2-12; p = 0.02). The results suggest that ICSI might be a preferred method of in vitro treatment in cases with high DFI. Efforts should be made to find options for pharmacologically induced reduction of DFI. The study was based on retrospectively collected data and prospective studies confirming the superiority of ICSI in cases with high DFI are warranted.
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| 28. |
- Tsarev, I., et al.
(författare)
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Evaluation of male fertility potential by Toluidine Blue test for sperm chromatin structure assessment
- 2009
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 24:7, s. 1569-1574
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Tidskriftsartikel (refereegranskat)abstract
- We have previously suggested that the Toluidine Blue (TB) test can be used for sperm chromatin structure assessment. In this study, we wished to evaluate the clinical applicability of the TB test in assessing male fertility potential using well-defined groups of fertile and infertile men. Sixty-three fertile and 79 infertile men were tested. Infertility thresholds for the proportion of sperm with abnormal [TB dark cells (TBDCs)] and normal [TB light cells (TBLCs)] chromatin structure were set by the ROC curve analysis. Thresholds of 45% TBDC and 20% TBLC were highly predictive for infertility (specificity of the test: 92 and 90%, respectively), but they were poor predictors of the fertility (sensitivity of the test: 42 and 32%, respectively). Odds ratio for infertility was 7.5 [95% confidence interval (CI): 2.7-20.8] when the 45% TBDC threshold was used and 4.4 (95% CI: 1.7-11.6) when the 20% TBLC threshold was used. The TB test can be suggested for clinical use as a complementary test for standard semen analysis to diagnose male infertility.
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| 29. |
- Vončina, Sladjana Malić, et al.
(författare)
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Sperm DNA fragmentation index and cumulative live birth rate in a cohort of 2,713 couples undergoing assisted reproduction treatment
- 2021
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Ingår i: Fertility and Sterility. - : Elsevier BV. - 0015-0282. ; 116:6, s. 1483-1490
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To study how the choice of the first assisted reproductive technology treatment type affects the cumulative live birth rate (CLBR) in couples with high sperm DNA fragmentation index (DFI). Design: Longitudinal cohort study. Setting: University-affiliated fertility clinic. Patient(s): A total of 2,713 infertile couples who underwent assisted reproductive technology treatment between 2007 and 2017 were included in the study. All in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments (up to three fresh treatments and all associated frozen-thawed embryo transfers) offered to the couples by the public health care system were included, in total 5,422 cycles. Intervention(s): None. Main Outcome Measure(s): The primary outcome was the CLBR. The secondary outcomes were the fertilization rate and the miscarriage rate. The IVF and ICSI groups were defined according to the method applied in the first treatment cycle. Result(s): In the IVF group, the CLBR values were higher for couples with normal DFI compared with those for couples with high DFI (≥20%) (48.1% vs. 41.6% for conservative CLBR estimate and 55.6% vs. 51.4% for optimal CLBR estimate after adjustment for female age, respectively). No DFI-dependent difference was seen in the ICSI group. Conclusion(s): Our results demonstrated that a high DFI predicts a statistically significantly lower CLBR if IVF and not ICSI is applied in the first cycle of assisted reproduction.
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| 30. |
- Zarén, Peter, et al.
(författare)
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Interaction between serum levels of Anti-Mullerian Hormone and the degree of sperm DNA fragmentation measured by sperm chromatin structure assay can be a predictor for the outcome of standard in vitro fertilization
- 2019
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 14:8
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Tidskriftsartikel (refereegranskat)abstract
- Serum levels of Anti-Mullerian Hormone (AMH) have been shown to be biomarker for prediction of the quantitative aspects of ovarian reserve. On the male side, sperm chromatin structure assay (SCSA) DNA fragmentation index (DFI) has been demonstrated to be an important predictor of outcomes in standard IVF procedures but to less degree in intracytoplasmic sperm injection procedures (ICSI). The purpose of this study was to investigate whether the combination of female AMH serum levels and sperm DFI adds to prediction of the outcome of assisted reproduction. A total of 352 couples was included (ICSI-148: IVF-204) A venous blood sample was drawn for AMH analysis before IVF/ICSI treatment. DFI was measured in the ejaculate used for assisted reproduction. Regression models for the following odds ratio calculations were constructed: for obtaining at least one Good Quality Embryo; for live birth in all procedures; for pregnancy in procedures where embryo transfer was performed; for miscarriage. For DFI increase by 10 percentage points (not increased DFI as reference) odds ratio for Good Quality Embryo was statistically significantly lower when AMH was at lower quartile (AMH <12 pmol/L; OR = 0.29, 95% CI: 0.14-0.59,) but not when AMH was at upper quartile (AMH ≥ 36 pmol/L; OR = 0.95, 95% CI: 0.43-2.13,). The marginal effect of an increase in DFI by 10 percentage points was statistically significant only when AMH < 25.2 pmol/L. Similar results were obtained as considers live birth following standard IVF. No interactions were seen for standard IVF in relation to the risk of miscarriage and for any of the outcomes when ICSI was used as method of treatment. We conclude that the impact of high DFI on the outcome of standard IVF is most pronounced if the female partner has relatively low AMH levels. This finding may help in defining the role of sperm DNA integrity testing in management of infertile couples. It may also explain some of the heterogeneity in results of studies focusing on predictive value of DFI measurements in assisted reproduction.
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