Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic male patients

Objective: To know whether sperm DNA fragmentation (SDF) affects the clinical outcomes in the cumulative transfers of an intracytoplasmic sperm injection (ICSI) cycle along with blastocyst transfers in couples with normozoospermic males. Methods: The study included 252 couples who underwent their first ICSI cycles along with blastocyst transfer and whose male partner semen samples were normozoospermic according to the World Health Organization 2010 criteria. All the couples were classified into two groups based on the SDF: the low SDF group (SDF≤30%, n=162) and the high SDF group (SDF>30%, n=90). Clinical as well as laboratory outcomes were correlated between the two groups. Sperm DNA fragmentation was assessed on the post-wash semen samples by acridine orange test. The main outcome measures were the live birth rate and miscarriage rate. Results: A significant decrease in the live birth rates was observed in the high SDF group compared to the low SDF group in fresh embryo transfer cycles (P<0.05). However, no significant difference was observed in the clinical outcomes either in the frozen embryo transfer cycles or in the overall cumulative transfer cycles (P>0.05). No significant difference was observed in the laboratory outcomes between the two SDF groups. A remarkable decrease in sperm motility was observed in the high SDF group compared to the low SDF group (P<0.05). Conclusions: Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic males.