The effect of sperm DNA fragmentation on clinical pregnancy and miscarriage following intrauterine insemination: updated systematic review and meta-analysis.

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-05-22 DOI:10.1016/j.urology.2025.05.036

Xinyan Liu, Li Zhao, Yayun Lin, Yi Liu

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引用次数: 0

Abstract

Objective: To investigate the effect of sperm DNA fragmentation (SDF) on clinical pregnancy and miscarriage after intrauterine insemination (IUI).

Methods: A systematic search of the PubMed, Embase, Web of Science and Cochrane Library was performed to identify all relevant studies published up to July 2024. The outcomes of interest were clinical pregnancy rate (CPR) and miscarriage rate (MR). Relative risk (RR) and 95% confidence intervals (CI) were calculated to analyze the effect of SDF on the CPR and MR after IUI.

Results: A total of 7 studies (4018 cycles) were included in the analysis of CPR. Among these, 3 studies (361 cycles) that mentioned MR were included in the analysis of MR. The meta-analysis revealed that high SDF didn't significantly affect the CPR (RR=0.82, 95% CI:0.52-1.29, P=0.38). The MR in the high SDF group was numerically higher than that in the low SDF group, but the trend was not statistically significant (RR=2.11, 95%CI:0.93-4.8, P=0.07). Furthermore, five studies that used the sperm chromatin structure assay to measure SDF were included in the meta-analysis. The pooled analysis still suggested no statistically significant difference in CPR between the high SDF group and the low SDF group (RR=0.76, 95%CI:0.43-1.31, P=0.32).

Conclusion: The pooled analysis suggested that high SDF didn't decrease the CPR after IUI. The MR tended to be higher in the high SDF group compared to the low SDF group, but the trend was not statistically significant. Given the limited number of included studies, the findings should be interpreted with caution.

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精子DNA片段对宫内授精后临床妊娠和流产的影响：最新的系统综述和荟萃分析。

目的：探讨精子DNA片段化（SDF）对临床宫内人工授精（IUI）后妊娠及流产的影响。方法：系统检索PubMed、Embase、Web of Science和Cochrane Library，确定截至2024年7月发表的所有相关研究。主要观察临床妊娠率（CPR）和流产率（MR）。计算相对危险度（RR）和95%置信区间（CI），分析SDF对IUI后CPR和MR的影响。结果：共纳入7项研究（4018个周期）。其中，有3项研究（361周期）涉及MR纳入MR分析。meta分析显示，高SDF对CPR无显著影响（RR=0.82, 95% CI:0.52 ~ 1.29， P=0.38）。高SDF组MR数值高于低SDF组，但差异无统计学意义（RR=2.11, 95%CI:0.93 ~ 4.8， P=0.07）。此外，五项使用精子染色质结构测定法测量SDF的研究被纳入meta分析。合并分析仍提示高SDF组与低SDF组CPR无统计学差异（RR=0.76, 95%CI:0.43 ~ 1.31， P=0.32）。结论：综合分析提示，高SDF不降低IUI后CPR。高SDF组MR有高于低SDF组的趋势，但无统计学意义。考虑到纳入的研究数量有限，研究结果应谨慎解读。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.