Sperm deoxyribonucleic acid damage in normozoospermic men is related to age and sperm progressive motility

摘要

Objective To evaluate sperm DNA fragmentation in normozoospermic male partners of couples undergoing infertility evaluation. Design Retrospective cohort study. Setting Clinical andrology laboratory. Patient(s) A total of 1,974 consecutive normozoospermic men selected from a larger cohort of 4,345 consecutive, nonazoospermic men presenting for infertility evaluation. Intervention(s) None. Main Outcome Measure(s) Clinical parameters, conventional semen parameters, and sperm DNA fragmentation assessed by flow cytometry-based TUNEL assay and reported as percent sperm DNA fragmentation (%SDF). Result(s) The mean (±SD) %SDF and the proportion of men with high %SDF (30%) were significantly lower in the normozoospermic compared with the entire cohort of 4,345 evaluable infertile men (17.6% ± 10.1% vs. 20.7% ± 12.4% and 11% vs. 20%, respectively). In the group of 1,974 normozoospermic men, %SDF was positively correlated with paternal age (r = 0.17) and inversely correlated with progressive motility (r = -0.26). In the subset of normozoospermic men with sperm parameters above the 50th percentile (≥73 × 106 sperm/mL, ≥55% progressive motility, and ≥14% normal forms, World Health Organization 2010 guidelines), 5% (4 of 83) had elevated %SDF (30%). Conclusion(s) In this large cohort of normozoospermic men presenting for infertility evaluation, DNA fragmentation level is related to sperm motility and paternal age, and 11% of these men have high levels of sperm DNA fragmentation. Furthermore, the data indicate that a nonnegligible proportion (5%) of normozoospermic men with high-normal sperm parameters may also have significant sperm DNA fragmentation.