TITLE:
Index of Sperm DNA Fragmentation in Men Seeking Treatment for Infertility through Assisted Reproductive Technology at the Mere Enfant Hospital in Bingerville, Ivory Coast
AUTHORS:
Wako-Tianwa Alice Tuo-Benie, Sadia Alfred Yaude, You Bazago Etienne Goulai Bi, Kouassi Hubert Oka, Ibrahiman Touré, Noumoutie Kourouma, Quidana Désirée Coulibaly, Philippe Iréné Agossou, Mimbra Olivia Bouatinin, Gnangoran Victior Yao
KEYWORDS:
Male Infertility, Semen Analysis, Sperm Morphology Analysis, SCD Test, Sperm DNA Fragmentation, Medically Assisted Reproduction, Ivory Coast
JOURNAL NAME:
Advances in Reproductive Sciences,
Vol.14 No.4,
November
3,
2026
ABSTRACT: Background: Infertility is a public health issue that affects 14% of the Ivorian population. Male infertility accounts for one-third of the causes of infertility in couples. Routine diagnosis relies on a semen analysis, which alone appears insufficient to determine the genetic causes. Thus, the use of much more sensitive tests, such as the sperm DNA fragmentation test, allows for the assessment of sperm DNA integrity, especially in men over the age of 40. The objective of this study is to determine the level of sperm DNA fragmentation in men undergoing assisted reproductive technology (ART) and to evaluate the correlation between sperm DNA fragmentation and the sperm parameters of these men. Methodology: A prospective, descriptive, and analytical study was conducted over a 10-month period from February 3 to December 5, 2025, involving all men enrolled in an assisted reproductive technology (ART) program at the time of our study at the fertility center of the Bingerville Mother and Child Hospital. Semen analysis was performed according to the 2021 WHO recommendations. Sperm DNA fragmentation was assessed using the SCD test with the Halosperm kit. As a reference, fragmentation indices below 15% are considered normal, rates between 15% and 30% are considered moderate, and those above 30% are considered severe. Results: The study included a total of 132 patients with a mean age of 47.31 ± 8.9 years. The high mean age in this cohort could be explained by the fact that patients were recruited through assisted reproductive technology (ART) programs, which require substantial financial resources, thereby limiting access for less affluent individuals—who are often younger. Urogenital infections accounted for infertility in 39.39% of cases, in addition to factors related to tobacco use (22%) and alcohol consumption (14.54%). Morphological abnormalities were primarily characterized by teratozoospermia in 49% of cases. Regarding the fragmentation rate, 22.73% of patients had severe DNA fragmentation (>30%). Furthermore, 32.58% had moderate fragmentation (15% - 30%). However, a significant association was observed between progressive motility, severe abnormalities in the sperm cytogram, and the rate of sperm DNA fragmentation, with various p-values Conclusion: A semen analysis/sperm cytogram alone is insufficient to determine the etiology of male infertility. Sperm DNA fragmentation may negatively impact fertilization.