Semen Quality is Associated with Sperm Aneuploidy and DNA Fragmentation in the United Arab Emirates Population.

Background

Sperm chromosome aneuploidy and the extent of sperm DNA fragmentation (SDF) are contributing factors to male infertility. Their extent can be measured using platforms such as sperm chromatin dispersion (SCD) and sperm fluorescence in situ hybridization (sFISH). Additional studies, however, are needed to understand the clinical applicability of these in vitro tests based on statistically validated thresholds. Aim: The primary objective of this study was to report the incidence of SDF and chromosomal aneuploidy with respect to sperm quality in the United Arab Emirates (UAE) population. In addition, we wished to establish clinically useful SDF and aneuploidy cutoff values. Materials and

Methods

A total of 302 subjects were enrolled in this study. The control group consisted of n = 100 (33.11%) reproductively-proven fertile men, and the case group consisted of n = 202 (66.89%) infertile men. The sperm quality of the cases was further subclassified as normospermia ("Normo," n = 88; 43.56%); teratozoospermia ("T," n = 40; 19.80%); oligoasthenoteratozoospermia ("OAT," n = 37; 18.32%); asthenoteratozoospermia ("AT," n = 19; 9.41%); or oligoteratozoospermia ("OT," n = 18; 8.91%). The assessments of SDF were done using SCD tests. Chromosomal aneuploidy (Chr 13, 18, 21, X, and Y) was investigated using sFISH. Furthermore, based on the fragmentation index, cases were divided into subfertile groups defined as low, medium, high, and severe. The Mann-Whitney test was used to set the upper threshold value for sFISH, and the odds ratio was used for SDF assessment.

Results

Cases having sperm quality "AT," "OAT," and "OT" together with the moderate, high, and severe subfertile groups had the highest DNA fragmentation indices: 31.58%, 27.03%, and 22.22%, respectively. In the sFISH analyses, groups with sperm quality "OAT," "T," and "OT" exhibited high degrees of abnormalities: 86.49%, 52.50%, and 50%, respectively. The most common chromosomal abnormalities found were "sex chromosome hyperploidy (XY18)" and "diploid (Chr 13, 21)." The incidences of sperm quality with respect to SDF and sFISH are also reported in detail.

Conclusions

This is the first study in the UAE which shows SDF and sFISH incidences together with sperm quality. This study also establishes SDF and sFISH cutoff values for the UAE population.