Objective: To investigate DNA fragmentation by using terminal deoxyribonucleotidyl transferase-mediated dUTP nick-end labeling in relation to World Health Organization parameters and computer-aided sperm analysis (CASA) in sperm to determine the possibility of obtaining a correlation among CASA parameters, sperm morphology, and DNA fragmentation.
Design: Sperm analysis according to World Health Organization parameters, terminal deoxyribonucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) for sperm DNA fragmentation, and CASA for sperm movement. Prospective study.
Setting: All the patients were under clinical management, consulting for hypofertility at a fertility center in France.
Patient(s): One thousand six hundred thirty-three men who were referred for infertility investigation, including a complete sperm analysis.
Intervention(s): Sperm analysis and DNA damage testing.
Main outcome measure(s): Sperm morphology, DNA fragmentation, and movement characteristics.
Result(s): One third of the patients had a TUNEL rate of >30%. Analysis of the 21 semen parameters tested revealed that 7 of them were significantly correlated with the TUNEL results.
Conclusion(s): World Health Organization sperm parameters and DNA damage are complementary, rather than strongly linked. This should be considered to more fully understand the paternal contribution in assisted reproductive technologies failures.