Sperm DNA damage or progressive motility: which one is the better predictor of fertilization in vitro?

Figures & data

Table 1. Comparison Between Semen Parameters, Age, and Sperm DNA Fragmentation with Fertilization Rate.

	Fertilization rate (%)
	≤40%	40–70%	>70%	P value
Semen volume (ml)	3.2 ± 0.2	2.9 ± 0.2	3.6 ± 0.2	NS
Sperm concentration (10^6/ml)	62.4 ± 7.0	73.9 ± 5.3	71.2 ± 4.5	NS
Progressive motility (%)	46.8 ± 3.3	57.9 ± 1.7	60.1 ± 2.2	0.038
Normal morphology (%)	29.1 ± 2.0	23.7 ± 1.4	25.4 ± 1.3	NS
Female age (years)	34.7 ± 0.6	34.6 ± 0.6	35.6 ± 0.4	NS
Men age (years)	37.1 ± 0.8	36.6 ± 0.8	36.9 ± 0.5	NS
DNA damage in DGC sperm (%)	44.0 ± 4.1	35.0 ± 2.7	30.9 ± 1.9	0.023
DNA damage in native semen (%)	59.9 ± 4.3	48.2 ± 3.2	42.6 ± 2.2	0.019

NS: non-significant (P > 0.05).

Table 2. The Effect of Standard Semen Parameters and DNA Fragmentation on Fertilization Rate.

			Multivalent
		Univalent OR (95% CI)	Model I OR(95% CI)	Model II OR(95% CI)	Model III OR 95% CI)
Semen volume (ml)	≤2 vs. >2	1.22 (0.53–2.82)	2.76 (0.70–11.32)	0.67 (0.15–2.89)	4.50 (0.41–114.50)
Sperm concentration (10^6/ml)	≤20 vs. >20	1.49 (0.40–5.69)	0.55 (0.02–6.51)	0.45 (0.05–3.22)	1.05 (0.06–33.52)
Progressive motility (%)	≤50 vs. >50	2.84 (1.37–5.89)	6.01 (1.57–24.78)	1.65 (0.50–5.49)	2.03 (1.38–11.22)
Normal morphology (%)	≤30 vs. >30	0.90 (0.40–1.76)	0.56 (0.19–1.69)	0.91 (0.30–2.78)	2.50 (0.41–16.01)
DNA damage in DGC sperm (%)	≤40 vs. >40	2.42 (1.24–4.73)	–	–	–
DNA damage in native semen (%)	≤40 vs. >40	3.66 (1.38–9.83)	–	–	–

OR: odds ratio; CI: confidence interval.

Models I, II, and III includes DNA fragmentation <40%, 40–70%, and >70% in the multivalent analysis, respectively.

Figure 1.  Relationship between sperm DNA fragmentation and fertilization rate. Bar chart showing decrease in fertilization rate with increase in DNA fragmentation in the native system. Significance at *P < 0.05, ***P < 0.001.

Figure 2.  Relationship between progressive motility and fertilization rate. Bar chart showing increase in fertilization rate with increase in progressive motility. Significance at **P < 0.01, ***P < 0.001.

Table 3. Prognostic Value of Progressive Motility and Sperm DNA Fragmentation to Determine Fertilization Rate in vitro.

	Progressive motility (>70%)	Sperm DNA fragmentation (≤40%)
Odds Ratio (95% CI)	4.81 (1.89–12.65)	24.18 (5.21–154.51)
Sensitivity (%)	57.89	66.33
Specificity (%)	77.78	93.33
PPV (%)	89.19	97.44
NPV (%)	36.84	38.89
RR (95% CI)	2.61(1.39–4.90)	9.50 (2.47–36.49)

PPV: positive predictive value; NPV: negative predictive value; RR: relative risk; CI: confidence interval.