Monica Muratori1, Sara Marchiani2, Lara Tamburrino2, Marta Cambi2, Francesco Lotti2, Ilaria Natali3, Erminio Filimberti4, Ivo Noci2, Gianni Forti2, Mario Maggi2, Elisabetta Baldi2. 1. Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy. Electronic address: monica.muratori@unifi.it. 2. Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy. 3. Seminology Laboratory, Azienda USL3 Pistoia, Pistoia, Italy. 4. Azienda Ospedaliero-Universitaria Careggi, Florence, Italy.
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.
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.
Authors: Christian De Geyter; Ursula Gobrecht-Keller; Astrid Ahler; Manuel Fischer Journal: J Assist Reprod Genet Date: 2019-08-28 Impact factor: 3.412