Number of Available Embryos: A Prediction Tool for Analyzing the Effect of Sperm DNA Fragmentation on Pregnancy Outcome of Patients Undergoing IVF Cycles from Embryology

Abstract

Sperm DNA fragmentation (SDF) can affect the pregnancy outcome of assisted reproduction technology. The cumulative live birth rate (CLBR), a new parameter of pregnancy outcome, attracts the attention of researchers to study the effect of SDF on CLBR. This study will focus on whether the number of available embryos (AEN) can be used as a predictor to investigate the effect of SDF on CLBR of in vitro fertilization (IVF) cycles. Our study included 1,347 couples who underwent IVF cycles and detected their SDF results by the sperm chromatin structure assay. Subsequently, CLBR and AEN on Day 3 were examined and compared between the SDF ≤ 30% and SDF > 30% group. The finding by the correlation analysis showed a strong correlation in CLBR and AEN, suggesting that AEN can be used as a predictor of CLBR. When comparing the two groups, significant differences were noticed in CLBR (81.1% vs. 71.5%, $P=0.009$ ) and AEN (8.10 ± 4.43 vs. 7.21 ± 4.27, $P=0.021$ ), revealing that SDF has an influence on both indicators. The results of the covariance analysis suggested that the available embryo rate per maturity oocyte was higher in the SDF ≤ 30% group, and the embryologic parameters showed a significant difference in the available embryo formation rate on Day 3, but not in the fertilization and cleavage rates, suggesting that SDF reduced the quality of embryos, which did not reach the morphological standard of the available embryos, and further reduced AEN and CLBR in the IVF cycles.