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Abstract To explore the association between sperm DNA fragmentation index (DFI) determined by the sperm chromatin structure assay(SCSA) and pregnancy outcome after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Method：Databases, such as Cochrane Library, EMbase, Springer Link, CNKI, Wanfang, and VIP were searched. The related literatures about the association between sperm DNA DFI(threshold of DFI was 27% or 30%) determined by SCSA and pregnancy outcome after IVF or ICSI were collected. The eligible literatures were selected by two researchers independently according to include and exclude standards, and related information was extracted from the eligible literatures by this two researchers independently, and a metaanalysis was conducted using STATA 12.0 software. Pregnancy outcomes included biochemical pregnancy (BP), clinical pregnancy (CP) and pregnancy loss (PL).The relationship between DFI and pregnancy outcome was evaluated used Relative Risk (RR) and 95% confidence intervals (95% CI). Results：9 cohort studies (2008 couples) were included for metaanalysis, and the result showed that higher DFI could significant increase the rate of BP and PL of women after ICSI( pooled RR (95 % CI) 1.24（1.001.52）,2.21（1.293.78）, respectively). However, higher DFI had no relationship to rate of CP of women after ICSI. And higher DFI had no any relationship to rate of BP, CP and PL of women after IVF. Conclusion：DFI detected by SCSA has value for predicting pregnancy outcome after ICSI, but had no value for pregnancy outcome after IVF. Further better designed clinical study with larger sample should be added to the metaanalysis for get more reliable conclusions.
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