DO DNA FRAGMENTATION INDEX AND HIGH DNA STAINABILITY HAVE ANY IMPACT ON FERTILIZATION RATES IN WOMEN UNDER 35 YEARS OF AGE HAVING MALE PARTNERS OVER 40 YEARS OF AGE, UNDERGOING IN VITRO FERTILIZATION AND INTRA CYTOPLASMIC INJECTION?

Objective

To evaluate if DNA Fragmentation Index(DNA-FI) and high DNA stainability(HDS) effect fertilization rates in couples where the women are at young age and men are at advanced paternal age(1).

Materials and methods

This study was conducted in an international IVF Center in Kyrenia, Northern Cyprus, with retrospective data analysis of 103 IVF/ICSI cycles where embryos were of women <35years and men over 40years of age. The data was searched between January 2022 and July 2024. All procedures were routine standardized procedures performed in the center. The women with previous poor ovarian responses, low antral follicle counts (<7 follicles) and AMH levels below 1.1 ng/ml were excluded. Male partners who used any antioxidants or required intervention for obtaining sperms were not included. The age of woman and male partners were recorded. Sperm Chromatin Structure Assays with the results of total progressive sperm count, progressive sperm motility, Kruger morphology criteria, spermatozoa concentration, spermatozoa viability, live sperms with open acrosomes, total acrosome losses, DNA-FI and HDS levels were evaluated. Short antagonist protocols were used in all patients. M2 oocyte numbers, 2PNs and fertilization rates were analyzed. Fertilization rates were classified in three groups as rates below competency value (<65%), competent value (between 65%-80%) and over benchmark value (>80 %) according to Vienna Consensus(2). Kruger strict criteria were classified as <4 and equal or >4. DNA-FI levels were analyzed if there was any correlation with fertilization rates. The DNA-FI levels were classified into 5groups as; <15,15.1-20,20.1-25,25.1-30 and >30. The sperm high DNA stainability was classified into 4groups as; <7.5, 7.6-10, 10.1-15 and >15.1. The groups were compared in terms of fertilization rates.

Results

There were 103women in the study. The descriptive data were analyzed. There were no azoospermic men as individuals requiring interventions to obtain sperms were excluded from the study. 38.83%(n=40) of men had teratospermia, having less than 4%normal sperm morphology due to Kruger strict criteria. Among all men, 31%(n=32) had increased DNA-FI, but only 1.94%(n=2) of men had increased HDS. There was no significant correlation between DNA-FI levels and fertilization rates. There was no significant difference among DNA-FI levels or HDS levels with fertilization rate groups.

Conclusion

In our study there was no correlation between DNA-FI levels and fertility rates. The DNA-FI and HDS were not affecting fertilization rates in our study group. Couples of <35years old women and >40years of men were selected with sperm parameters including DNA-FI and HDS.Small number of patients is a limitation to our current study. Also, clinical pregnancy rates and live birth rates are missing but they will be included in our further ongoing study.