The relationship between the DFI measured with the sperm chromatin structure assay (SCSA) and pregnancy outcomes following ART were retrospectively analyzed in 2,622 ART treatment cycles, of which 1,185 were intrauterine insemination (IUI) cycles, 1,221 were IVF cycles and 216 were ICSI cycles. Rates of pregnancy, early abortion, oocyte fertilization and good quality embryos from IVF and ICSI cycles were compared between the groups of low DFI (DFI ≤15%), medium DFI (15%< DFI <30%) and high DFI (DFI ≥30%). Additionally, the relationships between sperm DFI and male lifestyle variables such as age, body mass index, smoking, and alcohol consumption, as well as routine semen parameters, were analyzed.

Results

Clinical pregnancy rates following IUI among high, medium, and low sperm DFI groups were 12.5% (11/88), 14.3% (48/336), and 13.4% (102/761), respectively, with no statistical difference between the groups (P=0.88); however, early abortion rates among these groups were 27.3% (3/11), 14.6% (7/48), and 4.9% (5/102), respectively, and the difference was statistically significant (P=0.02). No significant differences in the rates of clinical pregnancy, early abortion, oocyte fertilization, or good quality embryos in IVF or ICSI cycles were detected among different DFI groups (P<0.05). Sperm DFI was negatively associated with sperm density, vitality and normal morphology; It was positively correlated with age, abstinence time and unhealthy lifestyles.

Conclusions

As an increasingly common technique for reproductive testing, sperm DFI has proven to be very valuable in male fertility evaluation, but its significance as a predictor of pregnancy outcomes following ART requires further investigation.