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연구소 마마파파&베이비의 핵심인 베이비 드림 난임 연구소는
그간의 연구학술 성과에 안주하지 않고,
늘 한계를 뛰어넘기 위해 노력합니다.

정자 DNA 파편화 지수가 높은 환자에서 ICSI가 전통적인 IVF에 비해 임신율을 유의하게 증가시켰다.

2016년 미국불임학회(ASRM) P-317 ICSI has significantly increased the pregnancy rate compared to the conventional IVF in the patients with high sperm DNA fragmentation index. (정자 DNA 파편화 지수가 높은 환자에서 ICSI가 전통적인 IVF에 비해 임신율을 유의하게 증가시켰다.)

J. Park,a K. Lee,b H. Sun, b H. Chi, a S. Kwak, a S. Kim, a Y. Kim, a J. Kim, b C. Yoo. a
aMamapapa&baby OBGY Clinic, Ulsan, Korea, Republic of;
bMamapapa&baby OBGY, Ulsan, Korea, Republic of.

OBJECTIVE

Sperm DNA fragmentation has been associated with adverse clinical outcomes such as low fertilization rate, poor embryo development, repeated IVF failure, and recurrent miscarriage. Although a few of studies reported that ICSI showed a beneficial effect on clinical outcomes in the patients with high sperm DFI, the beneficial effect of ICSI is still controversial, and the reason of the beneficial effect has not been clearly identified, yet. The purpose of this study was to assess the beneficial effect of ICSI in the patients with high sperm DNA fragmentation index (DFI).

DESIGN

The study included 458 patients who underwent IVF cycles from January 2015 to November 2015.

MATERIALS AND METHODS

458 semen samples were divided into two groups according to the sperm DNA fragmentation index (DFI); Low group (DFI≤30%, n=397), High group (DFI≥31%, n=61). Conventional semen analysis was performed according to the guidelines of WHO 2010. Halo sperm test was used for sperm DNA integrity determination. Both the Low and High groups were divided into conventional IVF and ICSI subgroups according to the method of fertilization.

RESULTS

There were no differences between the Low and High groups in the characteristics of the patients; mean age of the patients (36.5±3.9 vs. 36.7±3.8) and male (38.2±4.2 vs. 38.5±3.6), mean number of retrieved oocytes (8.7±5.1 vs. 8.7±5.6), endometrial thickness (10.0±2.2 vs. 10.3±2.2), and mean number of ET (1.9±0.4 vs. 1.9±0.4). Also no difference was observed between the two groups in the clinical outcomes; fertilization rate (76.9 vs. 80.1%), pregnancy rate (44.3 vs. 49.2%), and abortion rate (11.1 vs. 13.1%). In the Low group, the pregnancy and implantation rates (44.5 and 27.8%) of ICSI group were not different from the rates (42.9 and 26.1%, respectively) of conventional IVF group. However, in the High group, the pregnancy and implantation rates (55.3 and 34.4%) of ICSI group were significantly higher than the rates (28.6 and 16.0%, respectively, P<0.01) of conventional IVF group.

CONCLUSIONS

ICSI significantly increased the pregnancy rate and implantation rates in the patients with high sperm DFI. The beneficial effect of ICSI may be resulted from the selection of the sperm with rapid motility. Therefore, ICSI will be a practical and efficient strategy to overcome infertility in men with high sperm DFI.

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