Role Of Sperm DNA Damage And Acrosome Function Detection In The Diagnosis Of Male Infertility And The Predictive Value Of Assisted Reproduction Cycles

Objective: Normal sperm function is crucial for the fertilization,embryo development and implantation.The aim of the present study was to evaluate the relationship between sperm DNA damage,acrosome function and male infertility,male age,conventional semen parameters,clinical outcomes of IVF/ICSI cycles,to discuss the role of sperm function detection in the diagnosis of male infertility and the predict value of IVF/ICSI cycles.Methods: The present study was conducted into three parts.First,150 males with different fertility background were collected and divided into two groups,the infertility group and fertility group with 75 males per group.Sperm DNA fragmentations rate was detected by the sperm chromatin dispersion test,and sperm acrosome intact rate or spontaneous acrosome reaction rate was detected by FITC-PSA,differences of the semen conventional parameters and sperm functional parameters between the two groups were analyzed.Secondly,158 infertility males were collected,the correlation between sperm DNA fragmentations rate,sperm acrosome intact rate,spontaneous acrosome reaction rate and the male age,semen parameters were analyzed,and also the influence of density gradient centrifugation combined with swim-up method on sperm functional parameters was evaluated too.Thirdly,1750 IVF/ICSI cycles including 1480 IVF cycles and 270 ICSI cycles were involved with strictly controlling to limited the non-spermatozoon factors to minimum,sperm DNA fragmentations rate,sperm acrosome intact rate and spontaneous acrosome reaction rate were performed on the prepared semen samples that were simultaneously used for oocyte insemination by IVF or ICSI.Correlations between sperm functional parameters and fertilization rate,embryo development rate,clinical pregnancy outcomes were evaluated in IVF/ICSI cycles.Results: 1.There were significant differences between fertile male and infertile male for semen conventional parameters and sperm functional parameters(P<0.05),also there were significant differences for the sperm functional parameters between the subgroups divided by the semen conventional parameters(P <0.05).2.There were significant correlations between male age and semen volume,concentration,progressive motility(P<0.05),and sperm DNA fragmentation rate after sperm processing significantly correlated with male age(P<0.05).There were significant differences for semen volume,concentration and sperm DNA fragmentation rate between >40 group and ≦35 group or 36 to 40 group(P<0.05),but there was no statistically significant difference between the ≦35 group and 36 to 40 group(P>0.05).3.There were significant correlations between semen conventional parameters and sperm functional parameters(P<0.05),and significant correlations were detected among the three sperm functional parameters(P<0.05).4.There were significant differences for semen conventional parameters and sperm functional parameters before and after sperm processing by density gradient centrifugation combined with swim-up method(P<0.05).5.The results of multiple regression analysis showed that sperm DNA fragmentation rate,sperm acrosome intact rate,progressive motility were significant for predicting the fertilization failure or low fertilization in IVF cycles,and the cut-off values were 11.05%,81.10% and 83.85% respectively.6.There were no significant correlations between sperm parameters and embryo quality,blastocyst formation rate and quality in IVF cycles(P>0.05).7.There were significantly negative correlation between sperm DNA fragmentation rate and 2PN fertilization rate in ICSI cycles(r=-0.380,P<0.001),and the cut-off value was 21.00%.8.There were no significant correlations between sperm DNA fragmentation rate and embryo quality in ICSI cycle(r=0.052,P=0.071),but significantly negative correlation was detected between sperm DNA fragmentation rate and blastocyst formation rate(r=0.387,P=0.011),the cut-off value was 18.50%.9.There were no significant differences for semen conventional parameters and sperm functional parameters among patients who achieved live births,abortion or no pregnancy in IVF/ICSI cycles(P>0.05).Conclusions: 1.Sperm dysfunction may be one of the important factors leading to male infertility,sperm functional parameters can provide useful informations for the diagnosis of male infertility.2.Male age significantly influenced the semen quality and sperm function,male aged over 40 could present a significant reduction in semen volume,progressive motility,sperm DNA integrity,the advanced age male should receive sperm function detections before family planning.3.Infertility males with abnormal semen conventional parameters were prone to present sperm DNA damage and acrosome functional defection,and then should receive sperm function detections.4.Sperm DNA integrity and acrosome functions play important roles in the fertilization for IVF cycle,sperm DNA fragmentation rate,sperm acrosome intact rate and progressive motility rate of prepared semen samples could be regarded as independent predictive values for the fertilization rate in IVF cycles.5.Sperm DNA fragments significantly influenced the fertilization and embryo development in ICSI cycles,sperm DNA fragmentations rate of prepared semen samples can be regarded as independent predictive values for the fertilization rate and blastocyst formation in ICSI cycles.6.In the present study the clinical pregnancy outcome of IVF and ICSI cycles were not influenced by semen conventional parameters and sperm functional parameters.