Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis

REPRODUCTIVE BIOMEDICINE ONLINE

卷:38

Review

Tan, Justin^1,2,3  Taskin, Omur^1,2,3  Albert, Arianne^1,2,3  Bedaiwy, Mohamed A.^1,2,3 

[1] Univ British Columbia, Dept Obstet & Gynaecol, Vancouver, BC, Canada

[2] Childrens & Womens Hosp, Vancouver, BC, Canada

[3] Hlth Ctr British Columbia, Vancouver, BC, Canada

关键词: Meta-analysis;    Recurrent pregnancy loss;    Sperm DNA fragmentation;   

DOI  :  10.1016/j.rbmo.2018.12.029

来源: Elsevier

【 摘 要 】

Sperm DNA fragmentation (sDF) has emerged as a valuable tool for evaluating male fertility, yet the relationship between DNA fragmentation in the male gamete and idiopathic recurrent pregnancy loss (RPL) remains a topic of ongoing debate. Hence, a meta-analysis was conducted of 12 prospective and 2 retrospective studies involving 530 men with a history of RPL who underwent sDF testing compared with 639 fertile control participants. The main outcome measures were sDF measured by comet assay, TdT (terminal deoxynucleotidyl transferase)-mediated dUDP nick-end labelling (TUNEL), sperm chromatin dispersion (SCD) or sperm chromatin structure assay. Overall, couples with a history of idiopathic RPL demonstrated higher levels of sDF than fertile couples (average mean difference 11.98, P < 0.001). Subgroup analysis demonstrated a similar average mean difference between the RPL and control groups using SCD compared with 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.

【 授权许可】

Free