Factors Affecting Sperm DNA Fragmentation in Men with Unexplained Infertility

Abstract

Normal sperm DNA integrity is of paramount importance for normal fertilization, embryo development and normal pregnancy. Although semen parameters are normal, a significant proportion of men with unexplained infertility have high sperm DNA damage indicating that other biological or life- style factors as well as oxidative mechanisms may be involved. This case–control study sought to determine clinical, biochemical and lifestyle predictors associated with SDF in men with unexplained infertility. Seventy men were recruited and divided into two groups according to DNA fragmentation index: a normal-DNA group (n = 51) and an abnormal-DNA group (n = 19). The anthropometric measures, smoking, MDA and other oxidative-stress biomarkers—catalase (CAT) and superoxide dismutase (SOD)—and acute phase proteins—C-reactive protein (CRP), serum amyloid A (SAA), haptoglobin—were determined. Comparison There was no age difference between groups (P = 0.312) while BMI showed borderline result (P=0.06). The only clinical factor related to increased DNA damage of sperm was smoking, p = 0.04. The individuals with anomalous quantified DNA profiles had notably higher oxidative stress showing significantly elevated MDA concentrations (p = 0.002), and significant decrease of CAT (p= 0.01) and SOD activities (p= 0.003). In addition, all evaluated positive acute phase proteins were significantly elevated in men with abnormal DNA fragmentation as compared to those without (CRP: p = 0.022, SAA: p = 0.014, haptoglobin: p = 0.031). History medicals variables, such as diabetes mellitus (p = 0.41) and varicocele (p = 0.08), did not show statistical significance. In conclusion, results in the present study suggest that smoking adjunct to elevated systemic inflammation and enhanced oxidative stress contribute significantly to DNA damage among men with unexplained infertility. These findings emphasise the clinical value to include oxidative and inflammatory profiling in standard of care assessment for infertility and make a case for interventions targeting systemic inflammation and oxidative load in order to help improve reproductive outcome.

Keywords:

DNA Damage, MDA, CAT, SOD, CRP, SAA, Haptoglobin

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