Sperm chromatin structure assay predicts the outcome of intrauterine insemination

Objective: Sperm chromatin structure assay(SCSA),as a clinically practical technique for the analysis of DNA damage,is rarely reported in China.This study focuses on the correlation of DNA damage with the pregnancy rate of intrauterine insemination(IUI).Methods: We performed semen analysis for 482 couples undergoing IUI,calculated the DNA fragmentation index(DFI) by SCSA,and observed the relationship between DFI and the pregnancy rate of IUI.Results: Clinical pregnancy was achieved in 5(5.26%) of the 95 cases with DFI 25%,and in 59(15.25%) of the 387 cases with DFI ≤25%.Those with sperm DFI 25% had significantly lower rates of biochemical pregnancy and clinical pregnancy than those with DFI ≤25%(OR: 0.37,95% CI: 0.14-0.96 and OR: 0.38,95% CI: 0.16-0.97).No significant differences were found in the DFI of 54 cases between the first and the second cycle([15.05±7.98]% vs [17.25±12.18]%,P 0.05).Sperm DFI was significantly negatively correlated with sperm concentration,sperm motility and total progressively motile sperm count(P0.01).Conclusion: The pregnancy rate of IUI is significantly lower in couples with DFI 25% than in those with DFI ≤25%.Sperm DFI obtained from SCSA is partly correlated with sperm concentration and motility,and it is a robust predictor of the IUI outcome.