Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage

Background Previous studies have described an association between sperm with DNA damage and a history of recurrent miscarriage ( RM ), although it is not clear whether there is benefit in screening for sperm DNA fragmentation and to what extent DNA fragmentation impacts upon RM . Aims To identify what proportion of couples experiencing RM are affected by DNA fragmentation abnormalities. Materials and Methods In this retrospective study, between 2008 and 2013, couples with a history of recurrent miscarriage (≥3 first trimester miscarriages) were investigated comprehensively for known causes (karyotype, uterine, antiphospholipid syndrome, thrombophilia) and also by semen analysis, including DNA fragmentation [sperm chromatin structure analysis ( SCSA )]. Statistical analysis was performed on SPSS software with significance taken as P  < 0.05. Results There were 108 couples with a median sperm DNA fragmentation index ( DFI ) of 9.50%. Normal levels were found in 70.5% of men ( DFI  < 15%), 23% had high levels ( DFI 15–30%), and 6.5% had very high levels ( DFI  > 30%). Couples with otherwise unexplained recurrent miscarriage had significantly higher DFI than those with other causes identified on routine screening ( P  = 0.012). Conclusions In couples experiencing RM , 30% (32/108) of men had sperm with high levels of DNA fragmentation ( DFI  > 15%). This may be a contributing factor to the clinical syndrome of RM , and future clinical trials of therapies for these couples are warranted.