Sperm DNA quality predicts intrauterine insemination outcome: a prospective cohort study

Document Type


Peer Reviewed


Publication Date


NLM Title Abbreviation

Hum Reprod

Journal/Book/Conference Title

Human reproduction (Oxford, England)

PubMed ID


Start Page


End Page



BACKGROUND: We aimed to investigate whether sperm DNA quality may predict intrauterine insemination (IUI) outcome. METHODS: The study was designed in a prospective cohort fashion, at a tertiary centre for reproductive medicine. A total of 119 patients underwent 154 cycles of IUI. Parameters related to demography, cycle management and semen sample used for IUI were evaluated. Conventional semen parameters, morphology (strict criteria), sperm DNA fragmentation and stability [evaluated by terminal deoxynucleotidyl transferase-mediated dUDP nick-end labelling (TUNEL) and acridine orange staining under both acid and acid + heat denaturing conditions respectively] were measured. The main outcome measure was clinical pregnancy, defined as ultrasonographic visualization of intrauterine gestational sac(s). RESULTS: Logistic regression analyses were done on six sets of data, including all cycles combined, cycles with washed samples, first cycle of each couple, first cycle of each couple with washed samples, cycles stimulated with gonadotrophins and finally gonadotrophin-stimulated cycles with washed samples. The number of pre-ovulatory follicles on day of hCG, the age of the woman and the percentage of sperm with acid- + heat-resistant DNA were the parameters that predicted IUI outcome in most of these data subsets. For the gonadotrophin-stimulated cycles, age of the man appeared as a predictor as opposed to that of the woman; and for the cycles within this subgroup, where the semen sample was washed, sperm DNA fragmentation and age of the man were the only two parameters to predict IUI outcome. No samples with >12% of sperm having DNA fragmentation resulted in pregnancy. CONCLUSIONS: The number of follicles, age of the woman/man and sperm DNA quality may predict IUI outcome.


Adult, Cohort Studies, DNA/analysis, DNA Fragmentation, Drug Stability, Female, Gonadotropins/administration & dosage, Hot Temperature, Humans, Hydrogen-Ion Concentration, In Situ Nick-End Labeling, Infertility/therapy, Insemination, Artificial, Homologous, Logistic Models, Male, Middle Aged, Pregnancy, Prospective Studies, Sperm Count, Sperm Motility, Spermatozoa/chemistry/cytology, Treatment Outcome

Published Article/Book Citation

Human reproduction (Oxford, England), 17:12 (2002) pp.3122-3128.

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