Correlation of Paternal Homocysteine Level and Sperm DNA Fragmentation in Couple with Idiopathic Recurrent Early Pregnancy Loss

Background: Recurrent pregnancy loss is the traumatic event for couples in the effort to obtain offsprings. Various female etiologies have been extensively studied, but more than half of remain unknown. As a result of unification of sperm and oocyte, an embryo combined with any defect during spermatogenesis will also affect the quality of embryo consequently determining the pregnancy outcomes. Routine semen analysis failed to support the evidence of influence of defective sperm in recurrent pregnancy loss. Currently, examination of sperm DNA fragmentation has been added to evaluate the quality of sperm beside the routine semen analysis. We hypothesized that high sperm DNA fragmentation plays a role in the incidence of idiopathic recurrent early pregnancy loss. Beside that, the cause of sperm DNA fragmentation are numerous and remain controversial. This study was conducted to determine the impact of paternal hyperhomocysteinemia on high sperm DNA fragmentation and incidence rates of idiophatic recurrent early pregnancy loss. Material and methods: Fourty partners of idiopathic recurrent early pregnancy loss caes and 40 cases of control from normal male fertile population were included in this study. Blood and semen samples were collected for routine semen analysis, sperm DNA fragmentation, serum and seminal homocysteine. The results were then analyzed to determine the association between sperm and DNA fragmentation, serum homocysteine, seminal homocysteine and incidence rates of idiopathic recurrent early pregnancy loss. Results: incidence rates of idiopathic recurrent early pregnancy loss was significantly associated with sperm DNA fragmentation (p<0.05) and serum homocysteine (p<0.05). Idiopathic recurrent pregnancy loss partners had significantly higher DFI (p<0.05). Hyperhomocysteinemia appears to be associated with significantly increase of sperm DNA fragmentation (p<0.05). Conclusion: Paternal serum homcysteine and high sperm DNA fragmentation was significantly correlated with the incidence rates of idiopathic recurrent early pregnancy loss. Key words : hyperhomocysteinemia, DFI, idiopathic recurrent early pregnancy loss