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High sperm deoxyribonucleic acid fragmentation index is associated with an increased risk of preeclampsia following assisted reproduction treatment

Stenqvist, Amelie LU ; Bungum, Mona LU ; Pinborg, Anja Bisgaard ; Bogstad, Jeanette ; Englund, Anne Lis ; Grøndahl, Marie Louise ; Zedeler, Anne ; Hansson, Stefan R LU orcid and Giwercman, Aleksander LU (2025) In Fertility and Sterility 123(1). p.97-104
Abstract

OBJECTIVE: To study the association between sperm deoxyribonucleic acid fragmentation index (DFI) and the odds of preeclampsia and other adverse perinatal outcomes after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment.

DESIGN: A prospective cohort study including infertile couples undergoing conventional IVF or ICSI treatment and their children. Data regarding preeclampsia and perinatal outcomes were derived from the Swedish National Birth Register.

SETTING: University-affiliated fertility clinic.

PATIENT(S): A total of 1,594 infertile couples undergoing IVF or ICSI treatment and their 1,660 children conceived by assisted reproduction.

INTERVENTION(S): Sperm DFI measured by... (More)

OBJECTIVE: To study the association between sperm deoxyribonucleic acid fragmentation index (DFI) and the odds of preeclampsia and other adverse perinatal outcomes after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment.

DESIGN: A prospective cohort study including infertile couples undergoing conventional IVF or ICSI treatment and their children. Data regarding preeclampsia and perinatal outcomes were derived from the Swedish National Birth Register.

SETTING: University-affiliated fertility clinic.

PATIENT(S): A total of 1,594 infertile couples undergoing IVF or ICSI treatment and their 1,660 children conceived by assisted reproduction.

INTERVENTION(S): Sperm DFI measured by Sperm Chromatin Structure Assay.

MAIN OUTCOME MEASURE(S): The primary outcome was preeclampsia. The secondary outcomes were preterm birth (PTB), low birth weight, low Apgar score, and small for gestational age.

RESULT(S): With a DFI level of <20% as a reference, the odds ratio (OR) of preeclampsia statistically significantly increased in the group with a DFI level of ≥20% when IVF was used as the fertilization method (OR, 2.2; 95% confidence interval, 1.1-4.4). Already at the DFI levels of ≥10%, in IVF pregnancies, the OR of preeclampsia increased in a dose-response manner, from a prevalence of 3.1% in the reference group to >10% among those with a DFI level of ≥30%. The DFI was not associated with the OR of preeclampsia in the ICSI group. In the entire cohort, a DFI level of ≥20% was associated with an increased OR of PTB (OR, 1.4; 95% confidence interval, 1.0-2.0).

CONCLUSION(S): High DFI level was associated with increased odds of PTB and, in IVF pregnancies, also increased odds of preeclampsia.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Fertility and Sterility
volume
123
issue
1
pages
97 - 104
publisher
Elsevier
external identifiers
  • pmid:39122087
  • scopus:85205149355
ISSN
1556-5653
DOI
10.1016/j.fertnstert.2024.08.316
language
English
LU publication?
yes
id
102e93f7-6a44-4b3e-886f-439c201418e7
date added to LUP
2024-10-16 08:52:21
date last changed
2025-06-13 00:25:42
@article{102e93f7-6a44-4b3e-886f-439c201418e7,
  abstract     = {{<p>OBJECTIVE: To study the association between sperm deoxyribonucleic acid fragmentation index (DFI) and the odds of preeclampsia and other adverse perinatal outcomes after in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) treatment.</p><p>DESIGN: A prospective cohort study including infertile couples undergoing conventional IVF or ICSI treatment and their children. Data regarding preeclampsia and perinatal outcomes were derived from the Swedish National Birth Register.</p><p>SETTING: University-affiliated fertility clinic.</p><p>PATIENT(S): A total of 1,594 infertile couples undergoing IVF or ICSI treatment and their 1,660 children conceived by assisted reproduction.</p><p>INTERVENTION(S): Sperm DFI measured by Sperm Chromatin Structure Assay.</p><p>MAIN OUTCOME MEASURE(S): The primary outcome was preeclampsia. The secondary outcomes were preterm birth (PTB), low birth weight, low Apgar score, and small for gestational age.</p><p>RESULT(S): With a DFI level of &lt;20% as a reference, the odds ratio (OR) of preeclampsia statistically significantly increased in the group with a DFI level of ≥20% when IVF was used as the fertilization method (OR, 2.2; 95% confidence interval, 1.1-4.4). Already at the DFI levels of ≥10%, in IVF pregnancies, the OR of preeclampsia increased in a dose-response manner, from a prevalence of 3.1% in the reference group to &gt;10% among those with a DFI level of ≥30%. The DFI was not associated with the OR of preeclampsia in the ICSI group. In the entire cohort, a DFI level of ≥20% was associated with an increased OR of PTB (OR, 1.4; 95% confidence interval, 1.0-2.0).</p><p>CONCLUSION(S): High DFI level was associated with increased odds of PTB and, in IVF pregnancies, also increased odds of preeclampsia.</p>}},
  author       = {{Stenqvist, Amelie and Bungum, Mona and Pinborg, Anja Bisgaard and Bogstad, Jeanette and Englund, Anne Lis and Grøndahl, Marie Louise and Zedeler, Anne and Hansson, Stefan R and Giwercman, Aleksander}},
  issn         = {{1556-5653}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{97--104}},
  publisher    = {{Elsevier}},
  series       = {{Fertility and Sterility}},
  title        = {{High sperm deoxyribonucleic acid fragmentation index is associated with an increased risk of preeclampsia following assisted reproduction treatment}},
  url          = {{http://dx.doi.org/10.1016/j.fertnstert.2024.08.316}},
  doi          = {{10.1016/j.fertnstert.2024.08.316}},
  volume       = {{123}},
  year         = {{2025}},
}