Association between Sperm DNA Fragmentation and Idiopathic Recurrent Pregnancy Loss: A Systematic Review & Meta-Analysis

Publication date: Available online 22 December 2018Source: Reproductive BioMedicine OnlineAuthor(s): J Tan, O Taskin, A Albert, MA BedaiwyABSTRACTSperm DNA fragmentation (sDF) has emerged as a valuable tool for male fertility evaluation, yet the relationship between male gamete DNA fragmentation and idiopathic recurrent pregnancy loss remains a topic of ongoing debate. Hence, a meta-analysis was conducted among 12 prospective and 2 retrospective studies involving 530 males with a history of RPL who underwent sperm DNA fragmentation testing compared to 639 fertile controls. Main outcome measures were sDF measured by Comet, TUNEL, SCD, or SCSA assays. Overall, couples with a history of idiopathic RPL demonstrated higher levels of sDF compared to fertile couples (average mean difference (MD)=11.98, p<0.001). Subgroup analysis demonstrated a similar average MD between RPL and control using SCD compared to TUNEL, while mean paternal age and mean sperm motility in the RPL groups tested by meta-regression demonstrated no significant effect on the mean differences in sDF (p>0.10). These results support the diagnostic value of sDF over standard semen analysis as well as a possible paternally derived genetic origin of unexplained RPL. Further prospective studies are required to further assess the predictive utility of sDF for assessing couples with unexplained RPL.
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research