Clinical Application Of Sperm DNA Fragmentation Index In Assisted Reproduction

Objective: To investigate the association of DNA fragment index (DFI) with sperm morphology, sperm activity, sperm motility and their pregnancy outcomes in intrauterine insemination (IUI) or in vitro fertilization (IVF), and discuss the clinical application of DFI in male infertility and assisted reproduction.Methods: 154 cases of sperm samples from patients for IVF or IUI from Reproductive Center. DFI of sperm DNA was detected by flow cytometer; morphology, activity ratio and motility of sperm were observed by trichrome staining and routine sperm analysis, and pregnancy outcome of IVF and IUI was also recorded.Results: Normal sperm percentage was significantly negatively correlated with DFI (r=-0.192,P=0.042) and positively correlated with activity ratio of sperm (r=0.309,P=0.001). DFI was negatively correlated with sperm activity ratio and motility [a%,b%] both in group IVF and IUI, but DFI was positively correlated with age. There was statistical differences in activity ratio and normal morphological ratio between the states when DFI>25% and DFI<25%(P<0.05). The IUI group showed very low pregnancy rate when DFI>25%, but the IVF group showed no difference.Conclusion:1. DFI was significantly positively correlated with age, but was negatively correlated with normal sperm rate, activity ratio and percentage that ranked A and B.2. There was significantly difference in the activity ratio and normal morphological ratio between the sperms with DFI>25% or <25%.3. DFI=25% was regarded as a critical value for directing assisted reproduction treatment. IVF but not IUI is the advisable choice of assisted reproduction when DFI>25%.