Standard semen parameters remain the cornerstone of male infertility evaluation, though they often poorly reflect the likelihood of success in assisted reproductive technology (ART). This study evaluates sperm DNA fragmentation (SDF) as a diagnostic tool for male infertility and predictive biomarker for ART success. Semen samples were collected from 20 fertile donors and 40 infertile patients with abnormal semen parameters. A fraction of each sample was used for SDF assessment via TUNEL assay and flow cytometry, while the remaining portion was processed for conventional semen analysis and ART. Infertile patients exhibited higher SDF levels (32.77 ± 13.61%) compared to donors (22.19 ± 8.37%; p < 0.01), a difference that remained statistically significant across all subgroups stratified by semen parameters. Additionally, significant correlations were obtained between the percentage of SDF and sperm count (r = -0.4036), motility (r = -0.6377), and morphology (r = -0.2783). Regarding ART outcomes, patients with low-quality embryos exhibited higher SDF levels compared to those with high-quality embryos (30.02 ± 12.52% vs. 23.16 ± 8.41%; p = 0.0036). Receiver operating characteristic (ROC) curve analysis revealed an area under the curve (AUC) above 0.7 for the classification of male infertility as well as the assessment of embryo quality. Overall, our results support the utility of SDF as both a diagnostic biomarker for male infertility and a predictive indicator of embryo quality in ART, particularly in the presence of an oocyte-related female factor.
International journal of molecular sciences. 2025 Jun 30*** epublish ***
Coral Zurera-Egea, Sílvia Mateo, Sergi Novo, Marta Asensio, Montserrat Boada, Marta Antich, Sergi Rovira, Zaida Sarrate, Joan Blanco, Ester Anton
Genetics of Male Fertility Group, Unitat de Biologia Cel lular, Departament de Biologia Cel lular, de Fisiologia i d'Immunologia, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallés, Spain., Dexeus Fertility, Department of Obstetrics, Gynecology and Reproductive Medicine, Hospital Universitari Dexeus, 08028 Barcelona, Spain., Fertilab, 08017 Barcelona, Spain., Reproclinic, 08011 Barcelona, Spain.