{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:50:01Z","timestamp":1760233801874,"version":"build-2065373602"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We wanted to determine the sperm DNA fragmentation index (DFI) cutoff for clinical pregnancies in women receiving intra-uterine insemination (IUI) with this sperm and to assess the contribution of Human Papillomavirus (HPV) infection on sperm DNA damage and its impact on clinical pregnancies. Prospective non-interventional multi-center study with 161 infertile couples going through 209 cycles of IUI in hospital fertility centers in Flanders, Belgium. Measurement of DFI and HPV DNA with type specific quantitative PCRs (HPV 6, 11, 16, 18, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66 and 68) in sperm before its use in IUI. Clinical pregnancy (CP) rate was used as the outcome to analyze the impact on fertility outcome and to calculated the clinical cutoff value for DFI. A DFI criterion value of 26% was obtained by receiver operating characteristic (ROC) curve analysis. Couples with a male DFI &gt; 26% had significantly less CPs than couples with DFI below 26% (OR 0.0326; 95% CI 0.0019 to 0.5400; p = 0.017). In sperm, HPV prevalence was 14.8%\/IUI cycle. Sperm samples containing HPV had a significantly higher DFI compared to HPV negative sperm samples (29.8% vs. 20.9%; p = 0.011). When HPV-virions were present in sperm, no clinical pregnancies were observed. More than 1 in 5 of samples with normal semen parameters (17\/78; 21.8%) had an elevated DFI or was HPV positive. Sperm DFI is a robust predictor of clinical pregnancies in women receiving IUI with this sperm. When DFI exceeds 26%, clinical pregnancies are less likely and in vitro fertilization techniques should be considered.<\/jats:p>","DOI":"10.3390\/jcm10040717","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T18:45:00Z","timestamp":1613155500000},"page":"717","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Negative Impact of Elevated DNA Fragmentation and Human Papillomavirus (HPV) Presence in Sperm on the Outcome of Intra-Uterine Insemination (IUI)"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-6557","authenticated-orcid":false,"given":"Christophe","family":"Depuydt","sequence":"first","affiliation":[{"name":"Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium"},{"name":"Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9890-6254","authenticated-orcid":false,"given":"Gilbert","family":"Donders","sequence":"additional","affiliation":[{"name":"Femicare, Clinical Research for Women, 3300 Tienen, Belgium"},{"name":"University Hospital Antwerpen, 2650 Antwerp, Belgium"},{"name":"Department of Obstetrics and Gynecology, Regional Hospital Heilig Hart, 3300 Tienen, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludo","family":"Verstraete","sequence":"additional","affiliation":[{"name":"Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium"},{"name":"Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johan","family":"Beert","sequence":"additional","affiliation":[{"name":"Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium"},{"name":"Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium"},{"name":"Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, 2020 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geert","family":"Salembier","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Pathology, AML, Sonic Healthcare, 2020 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Bosmans","sequence":"additional","affiliation":[{"name":"Department of Hormonology and Reproductive Health, AML, Sonic Healthcare, 2020 Antwerp, Belgium"},{"name":"Intermediate Structure for Human Body Material, AML, Sonic Healthcare, 2020 Antwerp, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0894-3436","authenticated-orcid":false,"given":"Nathalie","family":"Dhont","sequence":"additional","affiliation":[{"name":"Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Kerkhofs","sequence":"additional","affiliation":[{"name":"Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7206-1537","authenticated-orcid":false,"given":"Willem","family":"Ombelet","sequence":"additional","affiliation":[{"name":"Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium"},{"name":"Faculty of Medicine and Life Sciences, Hasselt University, 3500 Hasselt, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"unstructured":"WHO (2010). 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