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IVF/ICSI pregnancy outcome negatively affected by SDF
70 studies; 9363 IVF; 6260 ICSI; 2121 mixed IVF/ICSI
By fertilization method
IVF studies: OR 1.15 (95% CI 1.05-1.27); P=0.003 ICSI studies: OR 1.12 (95% CI 1.01-1.25); P=0.025
By SDF assay type
TUNEL: OR 1.85 (95% CI 1.52-2.26); P<0.0001 SCD: OR 1.16 (95% CI 1.02-1.32); P=0.023 Comet: OR 4.15 (95% CI 3.04-5.68); P<0.0001 SCSA: OR 1.14 (95% CI 1.04-1.25); P=0.004
Female infertility factors excluded
1704 cycles: OR 1.37 (95% CI 1.11-1.68); P=0.003 (irrespective of method)
Simon et al., Best Pract Res Clin Obstet Gynaecol 2017 Esteves, 19
Translating the impact of SDF to Clinical Practice
IVF/ICSI Miscarriage
RR: 2.2 16 studies; 2969 couples (95% CI: 1.54–3.03); P<0.00001 Robinson et al, Hum Reprod 2012 Simon et al. Best Pract Res Clin Obstet Gynaecol 2017
OR~2.3 14 studies; 2756 couples (95% CI: 1.55–3.35; P<0.001) ICSI only: OR 2.7 (95% CI: 1.40–5.14; P=0.003)
Zhao et al, Fertil Steril 2014
Esteves, 20
The net effect for an ART Clinic performing 1,000 cycles/year with a CPR of 40% would be minus 82 pregnancies than expected or an absolute LBR reduction of 21%
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