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Meta-Analysis
. 2006 Sep-Oct;23(9-10):367-76.
doi: 10.1007/s10815-006-9066-9. Epub 2006 Oct 4.

Correlation of sperm DNA damage with IVF and ICSI outcomes: a systematic review and meta-analysis

Zhongxiang Li  1 , Liquan Wang, Jie Cai, Hefeng Huang
Affiliations
Meta-Analysis

Correlation of sperm DNA damage with IVF and ICSI outcomes: a systematic review and meta-analysis

Zhongxiang Li et al. J Assist Reprod Genet. 2006 Sep-Oct.

Abstract

Purpose: To assess the effects of sperm DNA damage, as determined by the TUNEL assay and the SCSA respectively, on the outcomes of IVF/ICSI treatment.

Methods: A Medline search (from Jan 1978 to Apr 2006) was performed, together with a manual search of the bibliographies of retrieved original papers and review articles. 8 articles met all inclusion/exclusion criteria, of which, 5 used the TUNEL assay and the other 3 used the SCSA. All these articles were included in separate meta-analysis. The meta-analysis was conducted using the RevMan software with fixed-effect model or random-effects model.

Results: As for articles using the TUNEL assay, the pooled results of IVF outcomes indicated that the clinical pregnancy rate (RR 0.68, 95% CI 0.54 to 0.85, P = 0.006), but not the fertilization rate (RR 0.79, 95% CI 0.54 to 1.16, P = 0.23) decreased significantly for patients with high degree of sperm DNA damage compared with those with low degree of sperm DNA damage. RRs of the ICSI outcomes indicated that there was no significant difference in either fertilization rate (RR 1.03, 95% CI 0.89 to1.18, P = 0.70) or clinical pregnancy rate (RR 0.76, 95% CI 0.55 to 1.04, P = 0.09) between these two groups. As for the SCSA papers, the pooled results showed no significant effects of sperm DNA damage on the clinical pregnancy rate after IVF (RR 0.58, 95% CI 0.25 to 1.31, P = 0.19) or ICSI (RR 1.18, 95% CI 0.81 to 1.74, P = 0.38).

Conclusion(s): Our meta-analysis indicates that sperm DNA damage, as assessed by the TUNEL assay, significantly decreases only the chance of IVF clinical pregnancy, but not that of either IVF fertilization or ICSI fertilization or ICSI clinical pregnancy. Besides, our results also reveal that sperm DNA damage, when assessed by the SCSA, has no significant effect on the chance of clinical pregnancy after IVF or ICSI treatment.

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Figures

Fig. 1
Fig. 1
Article selection process for meta-analysis
Fig. 2
Fig. 2
Meta-analysis of the TUNEL data on correlation of IVF/ICSI outcome with sperm DNA damage. Black squares indicate the risk ratio (RR) in each study and horizontal lines represent 95% credible interval (CI) of the RR. Black diamonds show the pooled estimates of RR with 95% CI. Fixed and random models, which assume homogenous and heterogenous studies respectively, were used to calculate the pooled RR. (A) IVF fertilization rate is not influenced by DNA damage (RR 0.79; 95% CI 0.54–1.16; P=0.23). (B) IVF pregnancy rate is decreased by DNA damage (RR 0.68; 95% CI 0.54–0.85; P=0.0006). (C) ICSI fertilization rate is not influenced by DNA damage (RR 1.03; 95% CI 0.89–1.18; P=0.70). (D) ICSI pregnancy rate not is influenced by DNA damage (RR 0.76; 95% CI 0.55–1.04; P=0.09)
Fig. 3
Fig. 3
Funnel plot of studies of IVF pregnancy with sperm DNA damage
Fig. 4
Fig. 4
Meta-analysis of the SCSA data on correlation of IVF/ICSI outcome with sperm DNA damage. (A) IVF pregnancy rate and (B) ICSI pregnancy rate are not influenced by DNA damage
See this image and copyright information in PMC

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