Exploring the Influence of Mild Sperm DNA Fragmentation on In Vitro Fertilization Outcomes in Women With Polycystic Ovary Syndrome

Ramesh Baradaran Bagheri; Samaneh Sadat Hosseini Quchani; Mitra Rahimi Fathkouhi

doi:10.34172/cjmb.2025.5040

E-ISSN : 2148-9696

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Original Article
Exploring the Influence of Mild Sperm DNA Fragmentation on In Vitro Fertilization Outcomes in Women With Polycystic Ovary Syndrome
Ramesh Baradaran Bagheri¹, Samaneh Sadat Hosseini Quchani¹, Mitra Rahimi Fathkouhi²
¹Department of Obstetrics and Gynecology, Faculty of Medicine, Kamali Infertility Center, Alborz University of Medical Sciences, Karaj, Iran ²Department of Reproductive Biology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
DOI: 10.34172/cjmb.2025.5040 Viewed : 7 times Downloaded : 4 times. Keywords : Sperm DNA fragmentation, DFI, Polycystic ovary syndrome (PCOS), In vitro fertilization (IVF), Intracytoplasmic sperm injection (ICSI), Infertility, Pregnancy outcomes
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Abstract

Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 4–20% of women worldwide and contributes to infertility in up to 80% of cases. Previous studies have shown that severe sperm DNA fragmentation index (DFI ≥25%) adversely affects IVF success and increases pregnancy complications. However, delaying IVF to treat DFI may lead to reduced ovarian reserve and greater psychological burden in women. The objective of this study is to assess the effect of mild sperm DNA fragmentation (15% ≤ DFI ≤ 25%) on IVF outcomes in PCOS women compared with controls. Materials and Methods: This retrospective study included 282 infertile couples undergoing their first In vitro fertilization (IVF)/Intracytoplasmic sperm injection (ICSI) cycle. Couples were stratified according to DFI level (<15% vs. 15–25%). Sperm DFI was measured using the halo test. Outcomes assessed included fertilization, embryo quality, clinical pregnancy, and live birth. Results: Men with DFI 15–25% had significantly lower sperm concentration (14.0±13.3 million/mL vs. 30.0±13.7 million/mL, P < 0.001), progressive motility (4.7±5.6% vs. 10.3±6.5%, P < 0.001), vitality (63.1±27.2% vs. 85.3±7.2%, P < 0.001), and fertilization rate (65.3±17.8% vs. 72.0±22.3%, P = 0.01). Clinical pregnancy was achieved in 40.1% of participants (34.4% live birth, 5.7% pregnancy loss), with no significant difference between DFI groups (P = 0.99). Conclusions: Mild DFI (15–25%) is associated with poorer sperm parameters but does not significantly affect pregnancy outcomes in IVF/ICSI cycles. Mild DFI elevation alone may not warrant delaying IVF treatment in PCOS patients.