Study for the diagnostic evaluation of the sperm DNA fragmentation index in a patient population of the fertility unit

Albert Blanco, Jordi Ramis, Carlos Aulesa, José Mª Gris

Laboratorio de Andrología, Unidad de Laboratorios Clínicos Vall d’Hebron, Barcelona. Servicio de Esterilidad Hospital Maternal Vall d’Hebron.

Summary:

Introduction: At present, parameters obtained via the common seminogram fail to provide complete information on the fertilizing potential of semen, as it is observed that between 10 to 15% of sterile males show a normal seminogram.

Objective: This study has verified the clinical utility of determination of the sperm DNA Fragmentation Index (DFI) as a diagnosis aid to male subfertility.

Design: 60 samples were processed from patients at the Fertility Unit, of which 42 patients showed proven infertility due to their clinical history, the remaining 18 were fertile males. The corresponding seminogram and FI were carried out using Halosperm® (Halotech D, Madrid) commercial equipment for the preparation of samples and a Sperm Class Analyzer (SCA) type Computer Assister Semen Assay® (CASA) for reading the sperm fragmentation.

Results: The FI sensitivity in diagnosis of subfertility was 54.8% and the specificity 66.7%, with a final diagnostic efficiency of 58.3%. The seminogram showed a sensitivity of 8.7% and a specificity of 50%, with diagnostic efficiency of 78.9%. The areas under the curve (AUC) are calculated from the ROC curves; it is shown that the FI presents a AUC=0.601 and the seminogram a AUC=0.679, which indicates that the seminogram has a higher diagnostic value.

Conclusions: Further to the data obtained, we reach the conclusion that the FI test does not appear to show a higher diagnostic value than the classic parameters of the seminogram. Likewise, we have observed that a pathological result in the FI can be a factor to consider for those couples who still have doubts about exploring other assisted reproductive techniques or Artificial Insemination by donor (AID).

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Revista Iberoamericana de Fertlidad y Reproducción Humana
Vol. 28 nº1 Enero-Febrero-Marzo 2011