Double-stranded sperm DNA fragmentation measured with neutral comet assay as a predictor of IVF outcomes: evidence from three European clinics in a multi-centred prospective study - PubMed

7 hours ago

Double-stranded sperm DNA fragmentation (dsSDF) measured by neutral comet assay is a strong, independent predictor of live birth following IVF.
Higher dsSDF levels correlate with reduced odds of live birth, with each 1-point increase in Average Comet Score (ACS) linked to 16% lower odds and each 1-point increase in Incidence of Damage (IOD) to 5% lower odds.
A pragmatic threshold of IOD ≥ 6% identifies couples with approximately half the odds of achieving a live birth compared to those with lower IOD at similar female ages.
The adverse impact of dsSDF on live birth is stronger at higher female ages, though female age itself remains a significant inverse predictor.
The study involved 302 males from three European IVF clinics over three years, with 126 healthy sperm donors as controls, and used multivariable logistic regression adjusting for age and center.
Limitations include focus on first IVF cycles only, potential center-level confounding, and lack of adjustment for cycle-level covariates like IVF/ICSI method or embryo transfer strategy.
Results support dsSDF as a clinically relevant biomarker that complements conventional semen parameters for predicting IVF outcomes.

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