ICSI in cases of sperm DNA damage: beneficial effect of oral antioxidant treatment

作者：Ermanno Greco, Stefania Romano, Marcello Iacobelli, Susanna Ferrero, Elena Baroni, Maria Giulia Minasi, Filippo Maria Ubaldi, Laura Francesca Rienzi, Jan Tesařík · 发表于：Human Reproduction · 年份：2005 · DOI：10.1093/humrep/dei091 · 被引用次数：262 · 研究领域：Sperm and Testicular Function、Reproductive Biology and Fertility、Reproductive biology and impacts on aquatic species

BACKGROUND: Most studies examining the use of ICSI for cases of elevated sperm DNA fragmentation report poor pregnancy and implantation rates. ICSI with testicular sperm samples has recently been suggested for these cases. Here we test a less invasive approach based on oral antioxidant treatment prior to ICSI with ejaculated spermatozoa. METHODS: Thirty-eight men with an elevated (> or =15%) percentage of DNA-fragmented spermatozoa in the ejaculate were treated with antioxidants (1 g vitamin C and 1 g vitamin E daily) for 2 months after one failed ICSI attempt. In 29 (76%) of these cases this treatment led to a decrease in the percentage of DNA-fragmented spermatozoa, and a second ICSI attempt was performed. Outcomes of the two attempts were compared. RESULTS: No differences in fertilization and cleavage rates or in embryo morphology were found between the ICSI attempts performed before and after the antioxidant treatment. However, a marked improvement of clinical pregnancy (48.2% versus 6.9%) and implantation (19.6% versus 2.2%) rates was observed after the antioxidant treatment as compared with the pretreatment ICSI outcomes. CONCLUSIONS: Oral antioxidant treatment appears to improve ICSI outcomes in those patiens with sperm DNA damage, in whom this treatment reduces the percentage of damaged spermatozoa.