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Sperm chromatin condensation defects and IVF outcomes: a retrospective cohort study

andrology
gynecology-and-obstetrics
urology
womens-health

Abstract

Background: The impact of sperm chromatin condensation defects (SCCD) on the clinical outcomes of in vitro fertilization (IVF) remains unclear, and there are inconsistencies in the results of existing studies. This study aimed to investigate the effects of SCCD on embryonic development, pregnancy, and neonatal outcomes in couples undergoing their first IVF cycle, thereby providing new evidence for the clinical application of SCCD assessment. Methods: In this retrospective cohort study, we included 647 couples who received their first IVF treatment at Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2017 to June 2024. Multivariable logistic regression was used to evaluate associations between SCCD and clinical outcomes, with stratification and interaction tests to identify potential effect-modifying subgroups. Generalized additive models and threshold effect analyses were further applied to explore potential nonlinear relationships and critical thresholds. Results: Elevated SCCD levels (≥30%) were correlated with abnormal semen parameters and reduced 2PN cleavage rates (all P <0.05), but showed no significant association with spontaneous abortion, gestational age, birth weight, or neonatal sex distribution (all P >0.05). Multivariate logistic regression indicated negative correlations between SCCD and both clinical pregnancy (OR=0.98, 95% CI: 0.96 – 0.99, P =0.01) and live birth rates (OR=0.98, 95% CI: 0.96 – 1.00, P =0.02). Notably, higher SCCD levels were associated with a 36% decrease in clinical pregnancy rates (OR=0.64, 95% CI: 0.41 – 1.00, P =0.05) and a 35% decrease in live birth rates (OR=0.65, 95% CI: 0.41 – 1.02, P =0.06). Stratified analysis showed no significant interactions between SCCD and covariates of interest (all P >0.05), but negative correlations were observed in individuals with higher reproductive potential. Moreover, we identified an S-shaped relationship between SCCD and live birth rate at thresholds of 10.6% (OR=0.86, 95% CI: 0.77 – 0.97, P =0.01) and 24.1% (OR=0.97, 95% CI: 0.93 – 1.00, P =0.07). Conclusions: These results suggest that SCCD negatively affects clinical outcomes, emphasizing the potential benefits of SCCD assessment before IVF.
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