Sperm deoxyribonucleic acid fragmentation assessment in normozoospermic male partners of couples with unexplained recurrent pregnancy loss: a prospective study

Objective To determine whether sperm DNA integrity in normozoospermic male partners plays a role in idiopathic recurrent pregnancy loss (RPL). Design Prospective, cohort study. Setting Academic tertiary care center. Patient(s) Group I: 26 male partners of women with unexplained RPL. Group II: 31 normozoospermic males with proven fertility. Intervention(s) Semen samples were collected by masturbation after 48–72 hours of abstinence. After liquefaction at room temperature, semen analysis was performed according to World Health Organization standards. Only samples with >20 × 10⁶ spermatozoa/mL with at least 50% progressive sperm motility and 30 % normal morphology were selected for the study. DNA fragmentation of the sperm was assessed with TUNEL assay followed by flow cytometric analysis. Main Outcome Measure(s) Sperm DNA fragmentation in both groups. Result(s) Mean DNA fragmentation (mean ± SD) was significantly more in men with RPL (36.8 ± 5) compared with controls (9.4 ± 2.7). Conclusion(s) Sperm DNA fragmentation may play a role in unexplained RPL despite normal semen analysis parameters.