›› 2012, Vol. 32 ›› Issue (8): 983-.doi: 10.3969/j.issn.1674-8115.2012.08.005

• Monographic report (Infertility and assisted reproductive technology) • Previous Articles     Next Articles

Correlation analysis between epididymal sperm DNA damage and outcome of intracytoplasmic sperm injection in patients with obstructive azoospermia

WANG Hong-xiang, CHEN Bin, HU Kai, FENG Tan, WANG Yi-xin, HUANG Yi-ran   

  1. Department of Urology, Shanghai Institute of Andrology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
  • Online:2012-08-28 Published:2012-08-29
  • Supported by:

    Shanghai Population and Family Planing Committee Foundation, 2010JG03

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Abstract:

Objective To investigate the epididymal sperm DNA damage in patients with obstructive azoospermia(OA), and explore its correlationship with the outcome of subsequent intracytoplasmic sperm injection (ICSI). Methods One hundred and twenty-one patients with OA suject to ICSI were selected as OA group, and 38 semen samples with normal range of parameters were served as control group. Patients in OA group underwent percutaneous epididymal sperm aspiration and microscopic analysis, while computer assisted semen analysis was conducted in control group. Acridine orange fluorescence staining tests of aspiration fluid/semen were carried out in both groups. The normal parameter of DNA fragmentation index (DFI) was below 30%, and both groups were subdivided into high DFI subgroups (DFI>30%) and low DFI subgroups (DFI<30%). The fertilization rate and clinical pregnancy rate of the subsequent ICSI in patients with OA were statistically analysed. Results The sperm density and the proportion of forward moving sperm of OA group were significantly lower than those of control group as a whole (P<0.01). There was no significant difference in the sperm density between high DFI subgroup and low DFI subgroup of OA group(P>0.05), while the proportion of forward moving sperm in high DFI subgroup of OA group was significantly lower than that in low DFI subgroup of OA group (P<0.01). The negative rate of acridine orange test in OA group was significantly lower than that in control group as a whole (P<0.01). As to the outcome of ICSI in OA group, there was no significant difference in the fertilization rate between high DFI subgroup and low DFI subgroup (P>0.05), while the clinical pregnancy rate in high DFI subgroup was significantly lower than that in low DFI subgroup (P<0.01). Conclusion It is essential to evaluate the sperm DNA for patients with OA before ICSI. Sperm DNA damage analysis for the epididymal sperm from diagnostic percutaneous epididymal sperm aspiration is an effective method for predicting ICSI outcome for patients with OA.

Key words: sperm DNA damage, obstructive azoospermia, percutaneous epididymal sperm aspiration, acridine orange test, intracytoplasmic sperm injection