Table 3.
Summary of studies on sperm deoxyribonucleic acid fragmentation in male infertility
| Author and year | SDF test | Participants/intervention | Outcome measures | Results |
|---|---|---|---|---|
| Zandieh et al., 2018[51] | SCD | Fertile men (n=30), unexplained infertility group (n=28) | Semen parameters, hydrogen peroxide, superoxide anion levels, and SDF | In the infertile group, sperm motility and normal morphology were significantly lower than in the control group Levels of hydrogen peroxide and superoxide anion were higher in the infertile group SDF was higher (15%) in the infertile group |
| Carlini et al., 2017[52] | TUNEL | Fertile men with proven fertility (n=114), recurrent pregnancy loss (n=112) | Seminal parameters and SDF | Sperm DNA integrity was impaired in the recurrent pregnancy loss group and the values were higher (8%) when compared to the fertile group |
| Atig et al., 2017[53] | TUNEL | Fertile men (n=50), infertile men (n=100; 40 OAT, 31 teratozoospermia, 29 asthenozoospermia) | SDF, nalondialdehyde levels, and semen parameters | SDF and malondialdehyde levels were increased in the infertile group and SDF correlated with semen parameters |
| Wiweko and Utami, 2017[54] | SCD | Fertile group (n=36), the infertile group with abnormal semen analysis except for azoospermia (n=78) | Sperm DFI | Sperm DFI was significantly higher in the infertile group when compared to the control fertile group |
| Martínez-Soto et al., 2016[55] | TUNEL | Treatment group (n=32), docosahexaenoic acid (1500 mg for 10 weeks), placebo group (n=25) | SDF and semen parameters | Significantly lower SDF levels in treatment group (−17.2%±2.8%) versus placebo group (+11.2%±1.9%) Insignificant effect on sperm parameters |
| Malić Vončina et al., 2016[56] | TUNEL | Fertile group (n=51), unexplained couple infertility (n=85) | SDF, MMP levels, semen parameters and natural conception rate | 31% of infertile men conceived naturally Infertile group SDF values <25% and with MMP values >62.5% had significantly increased odds for conception (odds ratio 5.22) |
| Bareh et al., 2016[57] | TUNEL | Fertile (normozoospermic) group (n=31), unexplained recurrent pregnancy loss (n=26) | SDF | SDF was significantly higher (27%) in men with RPL compared to fertile controls |
| Ni et al., 2016[58] | SCSA | Healthy donors (n=25), abnormal semen analysis, and varicocele (n=15) | DFI and malondialdehyde | Sperm DFI was significantly lower in healthy donors with proven fertility A strong correlation between sperm DFI and malondialdehyde levels |
| Muratori et al., 2015[59] | TUNEL | Fertile group with proven fertility (n=86), couples with unexplained infertility (n=348) | SDF with receiver operating characteristic curves | After matching for both age and semen parameters, only brighter and total SDF predicts male fertility At high values of total SDF, brighter SDF predicts natural conception better than total SDF |
| Gual-Frau et al., 2015[60] | SCD | 20 infertile men with Grade 1 varicocele treated with combined antioxidants for 3 months | SDF and sperm concentration | Significantly lower SDF levels (−22.1%). 31.3% fewer highly degraded sperm cells, significantly higher sperm concentration |
| Abad et al., 2013[61] | SCD measurement done following various periods of sperm storage 37°C | 20 infertile patients with asthenoteratozoospermia treated with combined antioxidants for 3 months | SDF and sperm parameters | Significant decrease in SDF with time Significant improvement in sperm concentration, motility, and morphology |
| Mangiarini et al., 2013[62] | TUNEL | Normzoospermia (n=18), teratozoospermia (n=14) | SDF and sperm morphology | In normozoospermic individuals, TUNEL positive normal morphology sperm was 4% Spermatozoa with vacuolated head or a small non-oval head had a significantly higher incidence of DNA fragmentation in both groups (12 and 13%, 19 and 13% respectively) |
| Vani et al., 2012[63] | COMET | 120 healthy human subjects, 120 men exposed to lead received treatment with Vitamin C (1000 mg) 5 consecutive days per week for 3 months | SDF and semen parameters | Significantly lower alkaline-labile sites and mean tail length of the COMET when compared to the control group Significant improvement in all semen parameters |
| Brahem et al., 2011[64] | TUNEL | Fertile group with proven fertility (n=30), men with teratozoospermia (n=70) | SDF and chromosomal aneuploidy | Teratozoospermic individuals show increased levels of SDF and chromosomal aneuploidy |
| Venkatesh et al., 2011[65] | SCSA | Fertile men (n=50), couples with unexplained couple infertility (n=100) | DFI, sperm count, motility, and morphology | DFI in infertile men was significantly higher (9%) in infertile men when compared to controls Semen parameters were negatively correlated with DFI |
| Alahmar et al.[9] | SCD | Fertile controls (n=40), infertile men with idiopathic oligoasthenospermia (n=65) treated with CoQ10 | Semen parameters, seminal SDF, seminal antioxidant markers and seminal CoQ10 level | Increased sperm concentration, motility, seminal antioxidant markers, and CoQ10 level and reduced SDF and ROS |
| Alahmar et al.[66] | SCD | Fertile controls (n=50), infertile men with idiopathic oligoasthenoteratospermia (n=50) treated with CoQ10 | Semen parameters, seminal SDF, seminal antioxidant markers, seminal CoQ10 level and sex hormones | Increased sperm concentration, progressive and total motility, seminal antioxidant and CoQ10 levels, and reduced SDF and ROS |
| Alahmar and Singh[26] | SCD | Fertile controls (n=58), infertile men with idiopathic oligoasthenospermia (n=130) treated with CoQ10 or centrum multivitamin | Semen parameters, seminal SDF, seminal antioxidant markers, seminal CoQ10 level and sex hormones | Both CoQ10 and centrum were effective in improving semen parameters, antioxidant capacity, and SDF, but the improvement was greater with centrum than with CoQ10 |
| Alahmar and Naemi[25] | SCD | Fertile controls (n=84), infertile men with idiopathic oligoasthenospermia (n=178) treated with CoQ10 and followed up for 24 months | Semen parameters, seminal SDF, seminal antioxidant markers, seminal CoQ10 level and pregnancy rate, time to pregnancy, and their predictors | Increased sperm concentration, motility, seminal antioxidant markers, and CoQ10 level and reduced SDF and ROS CoQ10 level, sperm concentration, motility male age, ROS and GPx were independent predictors of pregnancy and time to pregnancy |
SCD=Sperm chromatin dispersion, TUNEL=Terminal deoxynucleotidyl transferase dUTP nick end labeling, DNA=Deoxyribonucleic acid, SDF=Sperm DNA fragmentation, DFI=DNA fragmentation index, OAT=Oligoasthenoteratospermia, SCSA=Sperm chromatin structure assay, COMET=Single-cell gel electrophoresis, ROS=Reactive oxygen species, COQ10=Coenzyme Q10, MMP=Mitochondrial membrane potential, dUTP=2’-Deoxyuridine 5’-Triphosphate, RPL=Recurrent Pregnancy Loss, GPx=Glutathione Peroxidase