A study from Lund University in Sweden found that sperm DNA fragmentation is associated with a doubled risk of preeclampsia in in vitro fertilization (IVF) pregnancies. As cases of infertility rise and more couples are building their families using assisted reproductive technology (ART), it’s important to identify the factors that can influence pregnancy outcomes, even after successful fertilization.
The role of sperm DNA fragmentation on IVF pregnancies
Sperm DNA fragmentation (SDF) refers to the presence of breaks in the DNA of sperm cells. While some level of SDF is normal, higher levels can impair fertility and increase the risk of pregnancy complications. Men with a high DNA fragmentation index (DFI) can still be fathers using IVF, but not much is known about how this impacts pregnancy and the baby’s health. According to the study authors, around 20 to 30% of babies born through IVF have fathers with damaged DNA in their sperm. Half of the placenta’s DNA comes from the father and its development and function play a role in preeclampsia.
The study, published in Fertility and Sterility, investigated the association between sperm DFI and the risk of preeclampsia and other adverse outcomes following IVF and intracytoplasmic sperm injection (ICSI) treatments.
In the 841 couples who underwent IVF, a DFI of over 20% doubled the risk of the women developing preeclampsia. In cases where the DFI was below 20%, the risk of preeclampsia was comparable to natural pregnancies. For couples that underwent ICSI, there was no association with preeclampsia. A DFI of over 20% was also found to increase the risk of premature birth, regardless of the fertilization method used.
Implications for clinical practice
As highlighted by the study authors, these findings are of clinical importance. DFI analysis is not routinely performed, but it can give couples answers as to why they cannot get pregnant or why they’re experiencing recurrent miscarriages. DFI analysis can also influence ART choice: the findings of this study suggest that it may be preferable to perform ICSI instead of IVF in the case of a DFI level above 10-20% as this can reduce the risk of preeclampsia. Additionally, a DFI analysis can also be used to identify high risk pregnancies.
High DNA fragmentation is connected to the father’s overall health and in some cases, treatable. Encouraging lifestyle modifications, including diet, exercise, weight management, stress reduction and the avoidance of harmful substances can improve sperm quality.
Key Takeaway
Further research is needed to explore the underlying mechanisms by which sperm DNA damage contributes to pregnancy complications, but the findings of this study are already an insightful addition. By understanding the effect of sperm DNA fragmentation on pregnancy outcomes, fertility specialists can provide more personalized, evidence-based treatment plans and improve the chances of a successful pregnancy.
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