Oxidative deoxyribonucleic acid damage in sperm has a negative impact on clinical pregnancy rate in intrauterine insemination but not intracytoplasmic sperm injection cycles

To determine the level of DNA damage, both fragmentation and oxidative, in the sperm population used for intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI) and its impact on fertilization and clinical pregnancy rates. Design: A prospective clinical study. Setting: A tertiary care fertility clinic. Patient(s): Couples undergoing ICSI (n = 48) and couples undergoing IUI cycles (n = 53). Intervention(s): Assessment of both sperm DNA fragmentation using the TUNEL assay and oxidative DNA damage using the biomarker 8-hydroxy-2′-deoxyguanosine (8-OHdG) in the samples prepared and used for insemination. Main Outcome Measure(s): Achievement of a clinical pregnancy. Result(s): Sperm DNA fragmentation and 8-OHdG were highly correlated (r = 0.55) and 8-OHdG was significantly lower in those who achieved a clinical pregnancy after IUI (8.9% vs. 20.2%). A threshold value of 11.5% 8-OHdG was identified as a useful predictor of IUI success. No differences were found in sperm DNA fragmentation or 8-OHdG between pregnant and nonpregnant couples in ICSI cycles. Conclusion(s): 8-Hydroxy-2′-deoxyguanosine, a biomarker of oxidative DNA damage highly correlated with sperm DNA fragmentation, in human sperm DNA has significant value in predicting the chance of a clinical pregnancy after IUI but not ICSI in assisted reproductive technology.