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Meta-Analysis
. 2015 Jan;32(1):17-26.
doi: 10.1007/s10815-014-0374-1. Epub 2014 Nov 13.

Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: a meta-analysis

Zheng Zhang  1 , Leilei Zhu, Hesong Jiang, Hai Chen, Yun Chen, Yutian Dai
Affiliations
Meta-Analysis

Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: a meta-analysis

Zheng Zhang et al. J Assist Reprod Genet. 2015 Jan.

Abstract

Purpose: The purpose of this study was to carry out a meta-analysis for a comprehensive understanding and estimation of the association between sperm DNA Fragmentation Index (DFI) and pregnancy outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment.

Methods: Studies concerning the link of DFI with pregnancy outcome were included after literature search of database PUBMED, EMBASE, MEDLINE. Related information was extracted from the eligible studies by two independent authors and a meta-analysis was conducted by using STATA 12.0 software. Pregnancy outcomes consisted of biochemical pregnancy (BP), clinical pregnancy (CP) and pregnancy loss (PL). The studies included for meta-analysis were divided into three groups according to the DFI threshold value (DFI >27 %, 15-27 %, ≤15 % group). The odds ratio (OR ) and their 95 % confidence intervals (95 % CIs) were used to evaluate the association between DFI and pregnancy outcome.

Results: Twenty articles were included in our meta-analysis. The results indicated that infertile couples were more likely to get pregnant if DFI was less than threshold value (For threshold value > 27 % and 15-27 % group, combined overall OR (95 % CI) = 1.437 (1.186-1.742), 1.639 (1.093-2.459) respectively). However, when stratified by DFI detection methods, using sperm chromatin structure assay (SCSA) as the DFI test method, the results indicated a similar CP rate between groups with a high DFI or a lower DFI value (SCSA, For threshold value >27 % and 15-27 % group, combined overall OR (95 % CI) = 1.242(0.978-1.577), 1.480(0.921-2.377) respectively). The meta-analysis based on BP (overall OR (95 % CI) = 0.952 (0.697-1.302)) and PL((For DFI >27 %, 15-27 %, ≤15 % group, OR (95 % CI) = 0.786 (0.491-1.258), 1.509 (0.655-3.476), (0.538 (0.264-1.097) respectively) outcome yielded nonsignificant results.

Conclusions: The predication value of DFI for IVF or ICSI outcome is not confirmed in our meta-analysis. Further better designed studies with larger subjects involved are needed to better address this issue.

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Figures

Fig. 1
Fig. 1
the flow gram of the identification and selection of the studies
Fig. 2
Fig. 2
Forest plots for the overall and subgroup association (IVF or ICSI) of CP and DFI. a DFI threshold level > 27 % group; b DFI threshold level 15–27 % group c DFI ≤ 15 % group
Fig. 3
Fig. 3
Forest plots for the overall and subgroup association (DFI test methods) of CP and DFI. a DFI threshold level > 27 % group; b DFI threshold level 15–27 % group c DFI ≤ 15 % group
Fig. 4
Fig. 4
Forest plots for the overall and subgroup association(IVF or ICSI) of BP and DFI
Fig. 5
Fig. 5
Forest plots for the overall and subgroup association(IVF or ICSI) of PL and DFI. a DFI threshold level > 27 % group; b DFI threshold level 15–27 % group c DFI ≤ 15 % group
Fig. 6
Fig. 6
Forest plots for the overall and subgroup analysis(IVF or ICSI) of pregnant group versus non-pregnant group
See this image and copyright information in PMC

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