精子 DNA 片段化比率搭配電腦輔助精液形態運動參數可增益男性生育能力評估

林于巧¹，林欣達²，吳孟興²，蔡立忠³，陳鈺瀅²，洪貴香²，吳柏萱²，陳達生²，歐凰姿^3,4，鄭裕生¹

成功大學醫學院附設醫院泌尿部¹，成功大學醫學院附設醫院婦產部²，成功大學臨床藥理研究所³，成功大學藥學系⁴

Combining Sperm DNA Fragmentation Index with Computer-Assisted Semen Morphokinematic Parameters as a Better Window into Male Fertility

Yu-Chiao Lin¹, Hsin-Ta Lin², Meng-Hsing Wu², Li-Chung Tsai³, Yu-Ying Chen², Kuei-Hsiang Hung², Po-Hsuan Wu², Ta-Sheng Chen², Huang-Tz Ou^3,4, Yu-Sheng Cheng¹

¹Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

²Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

³School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

⁴Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Purpose:

This study aimed to assess the correlation between computer-assisted semen analyzer (CASA) morphokinematic parameters and sperm DNA fragmentation index (DFI), and the diagnostic value for male reproduction by combining semen morphokinematic parameters and DFI.

Materials and Methods:

Total fifty male participants were recruited, and all collected semen samples underwent semen analyses and SCD assays. The DFI was defined by the percentage of very small-size halo, without a halo, and degraded sperm cells. At least 500 sperm cells typically need to be evaluated in each specimen to produce the DFI. The predictive ability of CASA parameters and DFI (with different cutoffs, i.e., 15% and 20%) for infertility was assessed using receiver operating characteristic curve (ROC) analysis.

Results:

The CASA parameters (i.e., total motility [r =-0.57], progression motility [r= -0.55], rapidly progressive motility [r = -0.55]) were significantly correlated with DFI (p<0.001). The predictive ability of the 15%-cutoff DFI data was better than that of the 20%-cutoff or continuous DFI data.The model comprising the CASA parameters, 15%-cutoff DFI and 4%-cutoff normal morphology had the highest AUC (0.8125) for infertility.

Conclusion:

Combining the sperm DFI with CASA parameters might be a better diagnostic tool for male reproduction.

Keywords: sperm chromatin dispersion, DNA fragmentation index, computer-assisted semen analyzer, conventional semen analysis, male infertility.