The Importance of Sperm DNA Fragmentation Index (DFI) in Assisted Reproductive Technology (ART)

Research on sperm DNA fragmentation index (DFI) plays a significant role in understanding fertility, embryonic development, and pregnancy outcomes. However, there is ongoing debate about how DFI affects pregnancy success and the health of offspring in assisted reproductive procedures.

In this study, we examined clinical data from 6,330 patients who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) at two medical centers. Patients were divided into IVF and ICSI groups, and further categorized based on their DFI levels.

In the IVF group, patients were divided into three subgroups: Group A (<15% DFI), Group B (15–30% DFI), and Group C (≥30% DFI). Similarly, in the ICSI group, patients were divided into the same three subgroups based on DFI levels.

Statistical analysis was conducted on the collected data. We found no significant differences in basic patient characteristics among the three DFI groups. Additionally, sperm DFI did not significantly impact fertilization rates, pregnancy rates, stillbirth rates, or the number of birth defects.

However, we observed that miscarriage rates were significantly higher in IVF/ICSI groups with DFI >30% and DFI 15–30% compared to those with DFI <15%. Furthermore, the miscarriage rates in the ICSI group with DFI >30% were higher than in the DFI 15–30% group. Our analysis indicated a positive correlation between miscarriage rates and sperm DFI.

Moreover, infants born to IVF/ICSI groups with DFI >30% and DFI 15–30% had significantly lower birth weights compared to those with DFI <15%. Similarly, infants born to the ICSI group with DFI >30% had lower birth weights than those in the DFI 15–30% group. We found a negative association between birth weight and sperm DFI.

In conclusion, sperm DFI affects both miscarriage rates and birth weight in assisted reproductive procedures. Our analysis demonstrates a positive correlation between miscarriage rates and DFI, and a negative correlation between birth weight and DFI.