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Sperm DNA fragmentation index (DFI) can be analyzed by a flow cytometric assay after treatment with acid and acridine orange. In this prospective, cohort study, the value of DFI was determined in a semen analysis collected before fertility treatment (baselineDFI) in 146 couples and during 1-3 intrauterine inseminations (IUI) in 211 couples (511 cycles). The pregnancy rate (PR)/cycle was 9.9% if baselineDFI was &gt;10 and 21.7% if baselineDFI was ≤10, ( p &lt; 0.005). The live birth rate (LBR)/cycle was 5% if baselineDFI was &gt;10 and 14.2% if baselineDFI was ≤10 ( p &lt; 0.005). PR/patient was 23.1% if baselineDFI was &gt;10 and 45.5% if baselineDFI was ≤10 ( p &lt; 0.005). LBR/patient was 12.4% if baselineDFI was &gt;10 and 34% if baselineDFI was ≤10 ( p &lt; 0.005). When isolating non-stimulated IUI cycles and couples with female age &lt; 35, a significant difference in PR and LBR between couples with high DFI and low DFI was seen. Results suggest that DFI &gt; 10 could advice against timed coitus and non-stimulated IUI cycles. Analysis for DFI performed before treatment provides information about PR and LBR after IUI.

DNA Fragmentation in Human Spermatozoa and Pregnancy Rates after Intrauterine Insemination. Should the DFI Threshold Be Lowered?