{"title":"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。","authors":"Xinyan Liu, Li Zhao, Yayun Lin, Yi Liu","doi":"10.1016/j.urology.2025.05.036","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of sperm DNA fragmentation (SDF) on clinical pregnancy and miscarriage after intrauterine insemination (IUI).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23415,"journal":{"name":"Urology","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The effect of sperm DNA fragmentation on clinical pregnancy and miscarriage following intrauterine insemination: updated systematic review and meta-analysis.\",\"authors\":\"Xinyan Liu, Li Zhao, Yayun Lin, Yi Liu\",\"doi\":\"10.1016/j.urology.2025.05.036\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the effect of sperm DNA fragmentation (SDF) on clinical pregnancy and miscarriage after intrauterine insemination (IUI).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23415,\"journal\":{\"name\":\"Urology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-05-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.urology.2025.05.036\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.urology.2025.05.036","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
The effect of sperm DNA fragmentation on clinical pregnancy and miscarriage following intrauterine insemination: updated systematic review and meta-analysis.
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.
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.
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