The Association of Sperm DNA Fragment and Assisted Reproductive Outcomes: A Meta-Analysis

Abstract

Objective. To analyze the effect of sperm DNA fragmentation index (DFI) on the outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Methods. Literature search was conducted on English databases PubMed, Cochrane, and Embase to obtain eligible studies. Results. A total of 11 cohort studies were included and analyzed using the random effects model. The results illustrated that the IVF fertilization rate ( $\text{RR}=0.94$ , 95% CI: 0.77-1.14, $P=0.61$ ), pregnancy rate ( $\text{RR}=0.83$ , 95% CI: 0.57-1.21, $P=0.32$ ), and live birth rate ( $\text{RR}=0.53$ , 95% CI: 0.16-1.80, $P=0.31$ ) in the high DFI group were statistically insignificant with those in the low FI group. The correlations between DFI and ICSI fertilization rate ( $\text{RR}=0.79$ , 95% CI: 0.52-1.18, $P=0.25$ ), pregnancy rate ( $\text{RR}=0.89$ , 95% CI: 0.74-1.06, $P=0.18$ ), and live birth rate ( $\text{RR}=0.89$ , 95% CI: 0.70-1.14, $P=0.36$ ) were also not statistically significant. Conclusion. This study has observed no significant correlation between sperm DFI and assisted reproductive outcomes. Multicenter large-sample clinical trials are required to conclusively determine the impact of DNA damage on the clinical outcomes of assisted reproduction.