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Biosci Trends. 2019 May 12;13(2):152-159. doi: 10.5582/bst.2018.01292. Epub 2019 Apr 11.

Sperm DNA fragmentation valued by SCSA and its correlation with conventional sperm parameters in male partner of recurrent spontaneous abortion couple.

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Laboratory for Clinical Laboratory Testing, Hospital of Obstetrics and Gynecology, Fudan University Shanghai Medical College.
Department of Statistics and Psychology, College of Letters and Science, University of California Davis.
Laboratory for Reproductive Immunology, Hospital & Institute of Obstetrics and Gynecology, Shanghai Medical College, Fudan University.
The Academy of Integrative Medicine, Fudan University.
Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases.


The objective of this study is to evaluate the predictive value of sperm DNA fragmentation Index (DFI) in unexplained recurrent spontaneous abortion (RSA) and to investigate its correlation with conventional sperm parameters. Besides, we aimed to reveal the necessity of establishing a DFI clinical threshold of each laboratory for the prognostic diagnosis of RSA and establish our own DFI threshold. Semen samples were collected from male partners of RSA patients (n = 139) and healthy recent fathers (control, n = 200). DFI was tested using SCSA and conventional semen analysis was performed using an automatic semen analyzer. The DFI value and distribution were compared between the two groups using corresponding statistical software. The diagnostic threshold value was established by ROC curve. The correlation between DFI and the conventional semen parameters of the 139 cases was further analyzed using Student's t test and Mann-Whitney U test. Our result showed that DFI was significantly higher in RSA patients compared with normal donor controls. We established our own DFI threshold at 13.59%. There was only a weak partial correlation between DFI values and conventional sperm analysis parameters. Our present study suggested that DFI might be used as a valuable predictor for RSA independent of conventional sperm parameters. Additionally, we recommend that each laboratory should establish its own clinical DFI threshold for more precise prediction of RSA and we recommend that sperm DNA fragmentation test should be included in complete sperm quality assessment in addition to conventional semen analysis for RSA male partners.


DNA fragmentation index (DFI); Recurrent spontaneous abortion (RSA); Sperm Chromatin Structure Assay (SCSA); high DNA stainability (HDS); semen analysis; sperm DNA fragmentation (SDF)

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