الفهرس 
RECURRENT PREGNANCY LOSS (DEFINITIONS, MAGNITUDE OF THE PROBLEM AND CAUSES)Only 14 pages are availabe for public view
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Abstract
R
ecurrent spontaneous abortion is a devastating reproductive issue. More than 40% of cases remain unexplained and there is growing evidence demonstrating the impact of male factors. One focus area has been on the sperm DNA fragmentation.
This study aims to find out if there is an association between abnormally high sperm DNA fragmentation and recurrent spontaneous abortion.
Couples visiting recurrent pregnancy loss clinic, maternity hospital, ain shams university were assessed, couples with history of two or more spontaneous abortions, normal female partner work up and normal basic semen analysis were included as cases (n=40). Sperm DNA fragmentation was assessed using alkaline comet assay and DNA fragmentation index (DFI) was calculated for each case. DFI was compared to DFI of a group of matched controls (no previous history of abortion and at least one live birth) (n=40).
A significantly higher sperm DNA damage (as indicated by all used parameters; DFI, Arbitrary Units and Tail moment) was found in male partners of women with unexplained RPL compared to the control group. A correlation was found between the extent of DNA damage and the number of previous miscarriages. The ROC curve analysis for DFI results showed a cut off value 0.54 at which DFI is 95% sensitive and 100% specific with Positive predictive value 100%.
The cut off value detected by ROC curve analysis in our study, together with cut off values determined by further similar studies may be used to set a cut off value for an abnormal test result. The use of testicular sperms (known to have less DNA fragmentation) for ICSI may be offered to couples with unexplained RPL and a high sperm