Study question:Does sperm DNA fragmentation levels before and after semen processing and sperm morphology predict ICSI outcome ?
Summary answer:There was no statistically significant relationship between sperm DNA fragmentation before and after semen processing and sperm morphology and ICSI outcome .
Study design, size, duration:A Prospective comparative clinical study from 60 couples undergoing sperm DNA fragmentation before and after semen processing and sperm morphology prior to ICSI cycles was designed from the start of 2014 and for 2 yaer.
Participants/materials, setting, methods: 60 couples undergone ICSI cycles. Semen collected by masturbation. Basic sperm parameters evaluated. Ejaculates divided into three aliquots. An aliquot used to assess sperm DNA damage, and an aliquot processed by direct swim-up technique (n 30) or zeta test technique (n 30) then DNA damage assesed again to measure the difference. The third aliquot morphologically analyzed using Spearmac stain .fragmented DNA correlated in the two techniques of processing and with other parameters and morphology and reproductive success.
Main results and the role of chance:There was no statistically significant difference between group I and group II according to DNA fragmentation before and after processing . before processing group I (46.8±13.51) group II (43.45±14.19) p= 0.353 . after processing group I (24.57±9.36) group II (29.54±14.91) p= 0.127 . but as regard DNA fragmentation before and after processing in each group there was high statistically significant difference as in group I Before processing (46.8±13.51)and After processing(24.57±9.36) p= 0.001** and in group II Before processing (43.45±14.19)and After processing(29.54±14.91) p= 0.001** . as regard semen parameter there was no statistically significant difeffernce between the two groups in all parameter except the total abnormal forms where there was statistically significant difeffernce between group I (61.6±16.25) and group II (70.0±9.99) p= 0.019* .
Limitations, reasons for caution:This study findings should be interpreted with putting in our mind some limitations, including the small number of population, duration of infertility, the cause of infertility either male factor only or female factor only or both and that not all steps of the study were computrized which may be a limiting factor to achieve acurate results .
Wider implications of the findings:The zeta method have comprable results even better than swim up technique in decreasing DNA damage and appear to be easy to perform and is inexpensive, so zeta method can be used to select mature sperm in the expense of other techniques which still requires special laboratory equipment, which may not be feasible or available in all settings. however, there are certain limitations that should be noted. Low sperm recovery was noted following the application of zeta method, which limits its use for oligozoospermic samples,
Study funding/competing interest(s): Self funding and all authors declare no competing financial interests.
Trial registration number: ClinicalTrials.gov Identifier: NCT02520869.
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