(094) PREDICTORS OF ABNORMAL DNA FRAGMENTATION INDEX AND SUCCESSFUL PREGNANCY

Abstract Introduction Semen analysis is primarily used in initial evaluation of male factor infertility but does not provide insight into sperm DNA quality. DNA fragmentation index (DFI) and high DNA stainability (HDS) reflect the percentage of damage to sperm DNA and sperm with immature chromatin. Objective We sought to identify clinical predictors of DFI/HDS, and subsequent success of pregnancy. Methods This was a retrospective study of all men who underwent DFI/HDS testing for male infertility at a single academic institution between July 2016 and July 2023. Results We identified 199 men with median age of 39 years (range: 25-62). 23% of men had a diagnosis of a varicocele. Median partner age was 36 years (range: 20-46). 45%, 36%, and 26% of couples had a history of failed intrauterine insemination (IUI), in vitro fertilization (IVF), and miscarriage. Median sperm DFI and HDS were 19% (range: 4-72) and 11% (range: 2-40). 65% and 32% of the cohort had abnormal DFI and HDS >15%. Increasing age was a significant predictor of abnormal DFI (37.8 vs 40.1 years, p = 0.01). Men with abnormal HDS were significantly more likely to have a varicocele (18% vs 33%, p = 0.016). Decreased semen morphology was a predictor of abnormal DFI and HDS, though this did not reach statistical significance (4.2% vs 2.4%, p = 0.132 and 3.7% vs 1.7%, p = 0.094; Table 1). 18% of men underwent a testicular sperm retrieval procedure after DFI testing for planned IVF. Of these couples, 31% resulted in successful pregnancy. Among this subset, increased DFI thresholds were correlated to lower success rate of pregnancy (Table 2). Conclusions Increased age is a significant predictor of abnormal DFI, whereas concomitant varicocele predicts abnormal HDS. There is also a trend towards increased DFI and lower success rate of pregnancy. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific.