Sperm deoxyribonucleic acid fragmentation assessment in normozoospermic male partners of couples with unexplained recurrent pregnancy loss: a prospective study

Abstract

Objective: To determine whether sperm DNA integrity in normozoospermic male partners plays a role in idiopathic recurrent pregnancy loss (RPL).

Design: Prospective, cohort study.

Setting: Academic tertiary care center.

Patient(s): Group I: 26 male partners of women with unexplained RPL. Group II: 31 normozoospermic males with proven fertility.

Intervention(s): Semen samples were collected by masturbation after 48-72 hours of abstinence. After liquefaction at room temperature, semen analysis was performed according to World Health Organization standards. Only samples with >20 × 10(6) spermatozoa/mL with at least 50% progressive sperm motility and 30 % normal morphology were selected for the study. DNA fragmentation of the sperm was assessed with TUNEL assay followed by flow cytometric analysis.

Main outcome measure(s): Sperm DNA fragmentation in both groups.

Result(s): Mean DNA fragmentation (mean ± SD) was significantly more in men with RPL (36.8 ± 5) compared with controls (9.4 ± 2.7).

Conclusion(s): Sperm DNA fragmentation may play a role in unexplained RPL despite normal semen analysis parameters.

Keywords: Sperm DNA; TUNEL assay; recurrent pregnancy loss; unexplained infertility.