The relationship between sperm DNA fragmentation with morphokinetic parameters and men idiopathic infertility risk factors

Abstract

Relevance. Male infertility affects a significant proportion of married couples. However, standard semen analysis is often insufficient for assessing the actual functional potential of spermatozoa. Sperm DNA fragmentation (SDF) is an important molecular marker of impaired fertility and the prospect of assisted reproductive technology (ART) outcomes, yet its clinical application remains very limited.

Objective. To determine the relationship between the morphokinetic parameters of spermatozoa, the level of their DNA fragmentation, and the influence of modifiable risk factors (lifestyle and metabolic) in men with idiopathic infertility.

Materials and Methods. A retrospective study included 96 men (56 infertile and 40 fertile donors). The following assessments were performed: standard semen analysis, DNA fragmentation evaluation using the TUNEL assay with flow cytometry, and computer-assisted sperm analysis (CASA) for motility. Statistical analysis used non-parametric correlation methods and logistic regression.

Results. In the group of patients with idiopathic infertility, abnormalities in ejaculate parameters were significantly more frequent than in the group of fertile donors: asthenozoospermia (57.3% vs 32.3%; p < 0.01), oligoasthenozoospermia (13.5% vs 3.1%; p = 0.03), and teratozoospermia (39.6% vs 20.8%; p = 0.036). Risk factor analysis showed that smoking and impaired glucose tolerance were statistically significantly associated with the presence of infertility. Analysis of relationships revealed strong negative correlations between SDF level and sperm velocity parameters: straight-line (VSL) and curvilinear (VCL) velocity (r = –0.55 and r = –0.51, respectively; p < 0.01). Sperm morphology assessed by strict Kruger criteria also demonstrated a moderate negative association with SDF. The BCF (beat cross frequency) parameter showed a weak but significant positive correlation with the level of DNA fragmentation.

Conclusion. The study confirmed a significant association between male infertility and impairments in sperm motility and morphology, as well as with modifiable risk factors such as smoking and metabolic disorders. The findings justify the need for comprehensive diagnosis, including assessment of sperm DNA fragmentation and their kinetic parameters, and highlight the importance of lifestyle modification in the treatment of male infertility.