Sperm DNA fragmentation index and high DNA stainability do not influence pregnancy success after intracytoplasmic sperm injection

OBJECTIVE: To evaluate the ability of sperm DNA fragmentation index (DFI) and high DNA stainability (HDS) to influence the chance of achieving pregnancy in couples undergoing intracytoplasmic sperm injection (ICSI) cycles. DESIGN: A retrospective study evaluating couples who underwent an ICSI cycle between 2009 and 2018. SETTING: Reproductive center. PATIENT(S): Consecutive couples who underwent an ICSI cycle and had a semen analysis with subsequent DFI and HDS testing, evaluated using Sperm Chromatin Structure Assay. INTERVENTION(S): Measurement of DFI and HDS prior to ICSI cycle. MAIN OUTCOME MEASURE(S): To determine whether DFI or HDS of sperm was predictive of the number of ICSI cycles until the first clinical intrauterine pregnancy. RESULT(S): A total of 550 couples who underwent 1,050 ICSI cycles were analyzed. Of those, a total of 330 couples achieved pregnancy. As expected, in couples who achieved pregnancy, females were younger and underwent fewer cycles. Importantly, the DFI and HDS were similar between couples who achieved pregnancy (DFI% 12.9; HDS% 9.3) and couples who did not (DFI% 12.2; HDS% 9.1). A multivariable-adjusted analysis evaluating female age at the first cycle was associated negatively with pregnancy. CONCLUSION(S): Neither DFI nor HDS at baseline influenced the chances of a couple to achieve pregnancy after ICSI. Increased female age and couples who underwent more ICSI cycles were associated with lower chances of achieving pregnancy.