Tóm tắt
Tổn thương DNA của tinh trùng (DNA fragmentation index - DFI) có thể ảnh hưởng không chỉ đến quá trình thụ tinh mà còn lên cả sự biểu hiện gen và sự hình thành phôi thai. Tuy nhiên, tác động của DFI và chất lượng phôi lên kết quả mang thai vẫn còn gây tranh cãi. Một số nghiên cứu đã chỉ ra mối liên quan giữa DFI cao và chất lượng phôi với sự hình thành phôi và điểm chất lượng phôi. Các nghiên cứu gần đây đã báo cáo rằng DFI cao liên quan với sẩy thai sau ICSI và sẩy thai tự nhiên liên tiếp. Mặc dù vậy, cho đến nay điểm cắt giá trị DFI liên quan với kết cục bất lợi trong thai kỳ vẫn chưa rõ ràng. Ngưỡng DFI từ 20% đến 30% thường được sử dụng trong một số nghiên cứu để đánh giá mối quan hệ giữa DFI với các thông số tinh dịch, giữa DFI với chất lượng phôi và kết quả mang thai liên quan đến kỹ thuật hỗ trợ sinh sản. Yếu tố noãn cần được xem xét trong mối liên quan với sự hình thành phôi và thất bại thai kỳ. Do các kết quả nghiên cứu không đồng nhất, hiện chưa đủ bằng chứng để khuyến cáo thực hiện xét nghiệm phân mảnh DNA tinh trùng một cách thường quy trong đánh giá sinh sản nam. Tuy nhiên, các Hiệp hội đều kết luận rằng có bằng chứng mạnh về vai trò xét nghiệm phân mảnh DNA của tinh trùng trong các trường hợp thất bại làm tổ và sẩy thai liên tiếp (STLT). Các nghiên cứu sâu hơn về tế bào tinh trùng có thể phát hiện và ngăn ngừa các bất thường di truyền và biểu sinh có nguồn gốc từ người cha, giúp giảm tỷ lệ vô sinh do yếu tố nam giới. Đặc biệt phân mảnh DNA tinh trùng có thể có vai trò nguyên nhân mới của STLT hoặc thất bại thụ tinh.
Tài liệu tham khảo
Tài liệu tham khảo
1. Agarwal A, Majzoub A, Esteves SC, Ko E, Ramasamy R, Zini A. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Translational andrology and urology 2016;5(6):935.
2. Antonouli S, Papatheodorou A, Panagiotidis Y, et al. The impact of sperm DNA fragmentation on ICSI outcome in cases of donated oocytes. Archives of gynecology and obstetrics 2019;300(1):207-15.
3. Bach PV, Schlegel PN. Sperm DNA damage and its role in IVF and ICSI. Basic and clinical andrology 2016;26:15.
4. Basar MM, Kahraman S. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Translational andrology and urology 2017;6(Suppl 4):S574-S6.
5. Benchaib M, Lornage J, Mazoyer C, Lejeune H, Salle B, Francois Guerin J. Sperm deoxyribonucleic acid fragmentation as a prognostic indicator of assisted reproductive technology outcome. Fertility and sterility 2007;87(1):93-100.
6. Borges E, Jr., Zanetti BF, Setti AS, Braga D, Provenza RR, Iaconelli A, Jr. Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertility and sterility 2019;112(3):483-90.
7. Chi HJ, Kim SG, Kim YY, et al. ICSI significantly improved the pregnancy rate of patients with a high sperm DNA fragmentation index. Clinical and experimental reproductive medicine 2017;44(3):132-40.
8. Cho CL, Agarwal A. Role of sperm DNA fragmentation in male factor infertility: A systematic review. Arab journal of urology 2018;16(1):21-34.
9. Choi HY, Kim SK, Kim SH, Choi YM, Jee BC. Impact of sperm DNA fragmentation on clinical in vitro fertilization outcomes. Clinical and experimental reproductive medicine 2017;44(4):224-31.
10. Derijck, A.; van der Heijden, G.; Giele, M.; Philippens, M.; de Boer, P. DNA double-strand break repair in parental chromatin of mouse zygotes, the first cell cycle as an origin of de novo mutation. Hum. Mol. Genet. 2008, 17, 1922–1937.
11. Esbert M, Pacheco A, Soares SR, et al. High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected. Andrology 2018;6(5):697-706.
12. Esteves SC, Santi D, Simoni M. An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men. Andrology 2020;8(1):53-81.
13. Esteves, S.C.; Zini, A.; Coward, R.M.; Evenson, D.P.; Gosálvez, J.; Lewis, S.E.M.; Sharma, R.; Humaidan, P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia 2021, 53, e13874.
14. Gat I, Tang K, Quach K, et al. Sperm DNA fragmentation index does not correlate with blastocyst aneuploidy or morphological grading. PloS one 2017;12(6):e0179002.
15. Gill K, Jakubik J, Rosiak-Gill A, et al. Utility and Predictive Value of Human Standard Semen Parameters and Sperm DNA Dispersion for Fertility Potential. Int J Environ Res Public Health 2019;16(11):2004.
16. Hachemi M, Bensaada M, Rouabah A, et al. Effect of Spermatic Nuclear Quality on Live Birth Rates in Intracytoplasmic Sperm Injection. Journal of human reproductive sciences 2019;12(2):122-9.
17. Hervás, I.; Pacheco, A.; Gil Julia, M.; Rivera-Egea, R.; Navarro-Gomezlechon, A.; Garrido, N. Sperm deoxyribonucleic acid fragmentation (by terminal deoxynucleotidyl transferase biotin dUTP nick end labeling assay) does not impair reproductive success measured as cumulative live birth rates per donor metaphase II oocyte used. Fertil. Steril. 2022, 118, 79–89.
18. Javed A, Talkad MS, Ramaiah MK. Evaluation of sperm DNA fragmentation using multiple methods: a comparison of their predictive power for male infertility. Clinical and experimental reproductive medicine 2019;46(1):14-21.
19. Jerre E, Bungum M, Evenson D, Giwercman A. Sperm chromatin structure assay high DNA stainability sperm as a marker of early miscarriage after intracytoplasmic sperm injection. Fertility and sterility 2019;112(1):46-53 e2.
20. Kim GY. What should be done for men with sperm DNA fragmentation? Clinical and experimental reproductive medicine 2018;45(3):101-9.
21. Kim SM, Kim SK, Jee BC, Kim SH. Effect of Sperm DNA Fragmentation on Embryo Quality in Normal Responder Women in In Vitro Fertilization and Intracytoplasmic Sperm Injection. Yonsei medical journal 2019;60(5):461-6.
22. Le MT, Nguyen TAT, Nguyen HTT, et al. Does sperm DNA fragmentation correlate with semen parameters? Reproductive Medicine and Biology 2019;18(4):390-6.
23. Marita Hennessy , Laura Linehan, Rebecca Dennehy, Declan Devane, Rachel Rice, Sarah Meaney and Keelin O’Donoghue. Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group. Research Involvement and Engagement (2022) 8:18 https://doi.org/10.1186/s40900-022-00355-9
24. McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertility and sterility 2019;112(1):54-60.e3. (6)
25. Ménézo, Y.; Dale, B.; Cohen, M. DNA damage and repair in human oocytes and embryos: A review. Zygote 2010, 18, 357–365.
26. Minh Tam Le, Trung Van Nguyen, Thai Thanh Thi Nguyen, Hiep Tuyet Thi Nguyen, Duong Dinh Le, Quoc Huy Vu Nguyen. Predictive significance of sperm DNA fragmentation testing in early pregnancy loss in infertile couples undergoing intracytoplasmic sperm injection. Research and Reports in Urology 2021:13 313–323. https://doi.org/10.2147/RRU.S315300
27. Nellepalli S, Nagireddy S, Vembu R, Pandurangi M, Daniel M. Estimation of sperm DNA fragmentation index in ICSI cycles: does it affect the outcome? Fertility and sterility 2018;110(4):e291.
28. Newman, H.; Catt, S.; Vining, B.; Vollenhoven, B.; Horta, F. DNA repair and response to sperm DNA damage in oocytes and embryos, and the potential consequences in ART: A systematic review. Mol. Hum. Reprod. 2022, 28, gaab071.
29. Osman, A.; Alsomait, H.; Seshadri, S.; El-Toukhy, T.; Khalaf, Y. The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: A systematic review and meta-analysis. Reprod. Biomed. Online 2015, 30, 120–127.
30. Panner Selvam MK, Agarwal A. A systematic review on sperm DNA fragmentation in male factor infertility: Laboratory assessment. Arab journal of urology 2018;16(1):65-76.
31. Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, et al. Comprehensive analysis of sperm DNA fragmentation by five different assays: TUNEL assay, SCSA, SCD test and alkaline and neutral Comet assay. Andrology 2013;1(5):715-22.
32. Robinson L, Gallos ID, Conner SJ, et al. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Human reproduction (Oxford, England) 2012;27(10):2908-17.
33. Sakkas D, Alvarez JG. Sperm DNA fragmentation: mechanisms of origin, impact on reproductive outcome, and analysis. Fertility and sterility 2010;93(4):1027-36.
34. Sakkas, D.; Alvarez, J.G. Sperm DNA fragmentation: Mechanisms of origin, impact on reproductive outcome, and analysis. Fertil. Steril. 2010, 93, 1027–1036.
35. Salehi M, Afarinesh MR, Haghpanah T, Ghaffari Novin M, Farifteh F. Impact of sperm DNA fragmentation on ICSI outcome and incidence of apoptosis of human pre-implantation embryos obtained from in vitro matured MII oocytes. Biochemical and biophysical research communications 2019;510(1):110-5.
36. Siddhartha N, Reddy NS, Pandurangi M, Muthusamy T, Vembu R, Kasinathan K. The Effect of Sperm DNA Fragmentation Index on the Outcome of Intrauterine Insemination and Intracytoplasmic Sperm Injection. Journal of human reproductive sciences 2019;12(3):189-98.
37. Simon, L.; Zini, A.; Dyachenko, A.; Ciampi, A.; Carrell, D.T. A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome. Asian J. Androl. 2017, 19, 80–90.
38. Tan J, Taskin O, Albert A, Bedaiwy MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reproductive biomedicine online 2019;38(6):951-60.
39. Tello-Mora P, Hernández-Cadena L, Pedraza J, López-Bayghen E, Quintanilla-Vega B. Acrosome reaction and chromatin integrity as additional parameters of semen analysis to predict fertilization and blastocyst rates. Reproductive biology and endocrinology : RB&E 2018;16(1):102.
40. Walczak–Jedrzejowska R., Wolski J.K., & Slowikowska–Hilczer J. (2013), "The role of oxidative stress and antioxidants in male fertility", Central European journal of urology, 66,(1), pp. 60 - 67.
41. Ward W.S. (2010), "Function of sperm chromatin structural elements in fertilization and development", Mol Hum Reprod, 16,(1), pp. 30-6.
42. WHO (2020)"Infertility," https://www.who.int/news-room/fact-sheets/detail/infertility.
43. Wiweko B, Utami P. Predictive value of sperm deoxyribonucleic acid (DNA) fragmentation index in male infertility. Basic and clinical andrology 2017;27:1.
44. Zhang, Z.; Zhu, L.; Jiang, H.; Chen, H.; Chen, Y.; Dai, Y. Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: A meta-analysis. J. Assist. Reprod. Genet. 2015, 32, 17–26.
45. Zini A, Boman J, Belzile E, Ciampi A. Sperm DNA Damage is Associated With an Increased Risk of Pregnancy Loss After IVF and ICSI: Systematic Review and Meta-Analysis Editorial Comment. Human reproduction (Oxford, England) 2008;23:2663-8.
46. Zini A., & Sigman M. (2009), "Are tests of sperm DNA damage clinically useful? Pros and cons", J Androl, 30,(3), pp. 219-229.
1. Agarwal A, Majzoub A, Esteves SC, Ko E, Ramasamy R, Zini A. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Translational andrology and urology 2016;5(6):935.
2. Antonouli S, Papatheodorou A, Panagiotidis Y, et al. The impact of sperm DNA fragmentation on ICSI outcome in cases of donated oocytes. Archives of gynecology and obstetrics 2019;300(1):207-15.
3. Bach PV, Schlegel PN. Sperm DNA damage and its role in IVF and ICSI. Basic and clinical andrology 2016;26:15.
4. Basar MM, Kahraman S. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Translational andrology and urology 2017;6(Suppl 4):S574-S6.
5. Benchaib M, Lornage J, Mazoyer C, Lejeune H, Salle B, Francois Guerin J. Sperm deoxyribonucleic acid fragmentation as a prognostic indicator of assisted reproductive technology outcome. Fertility and sterility 2007;87(1):93-100.
6. Borges E, Jr., Zanetti BF, Setti AS, Braga D, Provenza RR, Iaconelli A, Jr. Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertility and sterility 2019;112(3):483-90.
7. Chi HJ, Kim SG, Kim YY, et al. ICSI significantly improved the pregnancy rate of patients with a high sperm DNA fragmentation index. Clinical and experimental reproductive medicine 2017;44(3):132-40.
8. Cho CL, Agarwal A. Role of sperm DNA fragmentation in male factor infertility: A systematic review. Arab journal of urology 2018;16(1):21-34.
9. Choi HY, Kim SK, Kim SH, Choi YM, Jee BC. Impact of sperm DNA fragmentation on clinical in vitro fertilization outcomes. Clinical and experimental reproductive medicine 2017;44(4):224-31.
10. Derijck, A.; van der Heijden, G.; Giele, M.; Philippens, M.; de Boer, P. DNA double-strand break repair in parental chromatin of mouse zygotes, the first cell cycle as an origin of de novo mutation. Hum. Mol. Genet. 2008, 17, 1922–1937.
11. Esbert M, Pacheco A, Soares SR, et al. High sperm DNA fragmentation delays human embryo kinetics when oocytes from young and healthy donors are microinjected. Andrology 2018;6(5):697-706.
12. Esteves SC, Santi D, Simoni M. An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men. Andrology 2020;8(1):53-81.
13. Esteves, S.C.; Zini, A.; Coward, R.M.; Evenson, D.P.; Gosálvez, J.; Lewis, S.E.M.; Sharma, R.; Humaidan, P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia 2021, 53, e13874.
14. Gat I, Tang K, Quach K, et al. Sperm DNA fragmentation index does not correlate with blastocyst aneuploidy or morphological grading. PloS one 2017;12(6):e0179002.
15. Gill K, Jakubik J, Rosiak-Gill A, et al. Utility and Predictive Value of Human Standard Semen Parameters and Sperm DNA Dispersion for Fertility Potential. Int J Environ Res Public Health 2019;16(11):2004.
16. Hachemi M, Bensaada M, Rouabah A, et al. Effect of Spermatic Nuclear Quality on Live Birth Rates in Intracytoplasmic Sperm Injection. Journal of human reproductive sciences 2019;12(2):122-9.
17. Hervás, I.; Pacheco, A.; Gil Julia, M.; Rivera-Egea, R.; Navarro-Gomezlechon, A.; Garrido, N. Sperm deoxyribonucleic acid fragmentation (by terminal deoxynucleotidyl transferase biotin dUTP nick end labeling assay) does not impair reproductive success measured as cumulative live birth rates per donor metaphase II oocyte used. Fertil. Steril. 2022, 118, 79–89.
18. Javed A, Talkad MS, Ramaiah MK. Evaluation of sperm DNA fragmentation using multiple methods: a comparison of their predictive power for male infertility. Clinical and experimental reproductive medicine 2019;46(1):14-21.
19. Jerre E, Bungum M, Evenson D, Giwercman A. Sperm chromatin structure assay high DNA stainability sperm as a marker of early miscarriage after intracytoplasmic sperm injection. Fertility and sterility 2019;112(1):46-53 e2.
20. Kim GY. What should be done for men with sperm DNA fragmentation? Clinical and experimental reproductive medicine 2018;45(3):101-9.
21. Kim SM, Kim SK, Jee BC, Kim SH. Effect of Sperm DNA Fragmentation on Embryo Quality in Normal Responder Women in In Vitro Fertilization and Intracytoplasmic Sperm Injection. Yonsei medical journal 2019;60(5):461-6.
22. Le MT, Nguyen TAT, Nguyen HTT, et al. Does sperm DNA fragmentation correlate with semen parameters? Reproductive Medicine and Biology 2019;18(4):390-6.
23. Marita Hennessy , Laura Linehan, Rebecca Dennehy, Declan Devane, Rachel Rice, Sarah Meaney and Keelin O’Donoghue. Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group. Research Involvement and Engagement (2022) 8:18 https://doi.org/10.1186/s40900-022-00355-9
24. McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertility and sterility 2019;112(1):54-60.e3. (6)
25. Ménézo, Y.; Dale, B.; Cohen, M. DNA damage and repair in human oocytes and embryos: A review. Zygote 2010, 18, 357–365.
26. Minh Tam Le, Trung Van Nguyen, Thai Thanh Thi Nguyen, Hiep Tuyet Thi Nguyen, Duong Dinh Le, Quoc Huy Vu Nguyen. Predictive significance of sperm DNA fragmentation testing in early pregnancy loss in infertile couples undergoing intracytoplasmic sperm injection. Research and Reports in Urology 2021:13 313–323. https://doi.org/10.2147/RRU.S315300
27. Nellepalli S, Nagireddy S, Vembu R, Pandurangi M, Daniel M. Estimation of sperm DNA fragmentation index in ICSI cycles: does it affect the outcome? Fertility and sterility 2018;110(4):e291.
28. Newman, H.; Catt, S.; Vining, B.; Vollenhoven, B.; Horta, F. DNA repair and response to sperm DNA damage in oocytes and embryos, and the potential consequences in ART: A systematic review. Mol. Hum. Reprod. 2022, 28, gaab071.
29. Osman, A.; Alsomait, H.; Seshadri, S.; El-Toukhy, T.; Khalaf, Y. The effect of sperm DNA fragmentation on live birth rate after IVF or ICSI: A systematic review and meta-analysis. Reprod. Biomed. Online 2015, 30, 120–127.
30. Panner Selvam MK, Agarwal A. A systematic review on sperm DNA fragmentation in male factor infertility: Laboratory assessment. Arab journal of urology 2018;16(1):65-76.
31. Ribas-Maynou J, Garcia-Peiro A, Fernandez-Encinas A, et al. Comprehensive analysis of sperm DNA fragmentation by five different assays: TUNEL assay, SCSA, SCD test and alkaline and neutral Comet assay. Andrology 2013;1(5):715-22.
32. Robinson L, Gallos ID, Conner SJ, et al. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Human reproduction (Oxford, England) 2012;27(10):2908-17.
33. Sakkas D, Alvarez JG. Sperm DNA fragmentation: mechanisms of origin, impact on reproductive outcome, and analysis. Fertility and sterility 2010;93(4):1027-36.
34. Sakkas, D.; Alvarez, J.G. Sperm DNA fragmentation: Mechanisms of origin, impact on reproductive outcome, and analysis. Fertil. Steril. 2010, 93, 1027–1036.
35. Salehi M, Afarinesh MR, Haghpanah T, Ghaffari Novin M, Farifteh F. Impact of sperm DNA fragmentation on ICSI outcome and incidence of apoptosis of human pre-implantation embryos obtained from in vitro matured MII oocytes. Biochemical and biophysical research communications 2019;510(1):110-5.
36. Siddhartha N, Reddy NS, Pandurangi M, Muthusamy T, Vembu R, Kasinathan K. The Effect of Sperm DNA Fragmentation Index on the Outcome of Intrauterine Insemination and Intracytoplasmic Sperm Injection. Journal of human reproductive sciences 2019;12(3):189-98.
37. Simon, L.; Zini, A.; Dyachenko, A.; Ciampi, A.; Carrell, D.T. A systematic review and meta-analysis to determine the effect of sperm DNA damage on in vitro fertilization and intracytoplasmic sperm injection outcome. Asian J. Androl. 2017, 19, 80–90.
38. Tan J, Taskin O, Albert A, Bedaiwy MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reproductive biomedicine online 2019;38(6):951-60.
39. Tello-Mora P, Hernández-Cadena L, Pedraza J, López-Bayghen E, Quintanilla-Vega B. Acrosome reaction and chromatin integrity as additional parameters of semen analysis to predict fertilization and blastocyst rates. Reproductive biology and endocrinology : RB&E 2018;16(1):102.
40. Walczak–Jedrzejowska R., Wolski J.K., & Slowikowska–Hilczer J. (2013), "The role of oxidative stress and antioxidants in male fertility", Central European journal of urology, 66,(1), pp. 60 - 67.
41. Ward W.S. (2010), "Function of sperm chromatin structural elements in fertilization and development", Mol Hum Reprod, 16,(1), pp. 30-6.
42. WHO (2020)"Infertility," https://www.who.int/news-room/fact-sheets/detail/infertility.
43. Wiweko B, Utami P. Predictive value of sperm deoxyribonucleic acid (DNA) fragmentation index in male infertility. Basic and clinical andrology 2017;27:1.
44. Zhang, Z.; Zhu, L.; Jiang, H.; Chen, H.; Chen, Y.; Dai, Y. Sperm DNA fragmentation index and pregnancy outcome after IVF or ICSI: A meta-analysis. J. Assist. Reprod. Genet. 2015, 32, 17–26.
45. Zini A, Boman J, Belzile E, Ciampi A. Sperm DNA Damage is Associated With an Increased Risk of Pregnancy Loss After IVF and ICSI: Systematic Review and Meta-Analysis Editorial Comment. Human reproduction (Oxford, England) 2008;23:2663-8.
46. Zini A., & Sigman M. (2009), "Are tests of sperm DNA damage clinically useful? Pros and cons", J Androl, 30,(3), pp. 219-229.
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