Sperm DNA Fragmentation may Influence IUI Outcome but could be Treated by ICSI: Evidence from Human Sperm Bank

Objective To determine the correlation between semen parameters, sperm DNA damage,progressive motility(PR), morphology and intrauterine insemination(IUI)/ intracytoplasmic sperm injection(ICSI) outcomes.Methods All the donors providing the samples in this study were recruited by Shanghai Human Sperm Bank. For IUI, 122 donors were divided into group A(n=60) and group B(n=62). Group A had a higher pregnancy rate while group B had a lower pregnancy rate(3.86 ± 1.50% vs 0.18 ± 0.52%). For ICSI, 45 donors were divided into group C with a higher pregnancy rate(77.78 ± 17.21%, n=23), group D with a lower pregnancy rate(40.73 ± 19.19%, n=22) and group E with an average pregnancy rate in the sperm bank(48.96 ± 12.08%, n=23). Semen analysis, morphology and DNA damage were assessed on samples retained in the sperm bank. Fresh semen samples were also collected and corresponding semen analyses data was included along with the pregnancy rates.Results No significant difference was found in the population characteristics between groups A and B, while there was a significant difference in sperm DNA fragmetation index(DFI) and morphology between the two groups(P<0.05), but not in other semen parameters(P>0.05). There was no significant difference in population characteristics between groups C, D and E while the DFI of group D was significant higher than groups C and E(P<0.01), but there was no significant difference in other semen parameters(P>0.05).Conclusion DFI might be a good predictor for IUI outcomes. Infertile couples with a high DFI should choose ICSI treatment instead of IUI. DFI should be a routine screening marker used to screen for sperm donors.