Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome

Mona Bungum, P. Humaidan, A. Axmon, M. Spano, L. Bungum, J. Erenpreiss, A. Giwercman

Research output: Contribution to journalArticlepeer-review

584 Citations (Scopus)


Background: The sperm chromatin structure assay (SCSA) has been suggested as a predictor of fertility in vivo as well as in vitro. The available data however, have been based on limited numbers of treatments. We aimed to define the clinical role of SCSA in assisted reproduction. Methods: A total of 998 cycles [387 intrauterine insemination (IUI), 388 IVF and 223 ICSI] from 637 couples were included. SCSA results were expressed as DNA fragmentation index (DFI) and high DNA stainable (HDS) cell fractions. Outcome parameters were biochemical pregnancy (BP), clinical pregnancy (CP) and delivery (D). Results: For IUI, the odds ratios (ORs) for BP, CP and D were significantly lower for couples with DFI >30% as compared with those with DFI ≤30%. No statistical difference between the outcomes of ICSI versus IVF in the group with DFI ≤30% was seen. In the DFI >30% group, the results of ICSI were significantly better than those of IVF. Conclusions: DFI can be used as an independent predictor of fertility in couples undergoing IUI. As a result, we propose that all infertile men should be tested with SCSA as a supplement to the standard semen analysis. When DFI exceeds 30%, ICSI should be the method of choice.

Original languageEnglish
Pages (from-to)174-179
Number of pages6
JournalHuman Reproduction
Issue number1
Publication statusPublished - Jan 2007
Externally publishedYes


  • ICSI
  • IUI
  • IVF
  • SCSA
  • Sperm DNA

Field of Science*

  • 3.4 Medical biotechnology
  • 3.1 Basic medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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