Sperm DNA Fragmentation: A New Guideline for Clinicians
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Authors
Agarwal, Ashok
Majzoub, Ahmad
Baskaran, Saradha
Kumar Panner Selvam, Manesh
Cho, Chak Lam
Henkel, Ralf
Finelli, Renata
Leisegang, Kristian
Sengupta, Pallav
Barbarosie, Catalina
Issue Date
2020-08-06
Type
Article
Language
en_US
Keywords
Assisted Reproductive Techniques , Clinical Guidelines , Infertility , Oxidative Stress , Sperm DNA Fragmentation
Alternative Title
Abstract
Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations. This article provides an overview of SDF types, origin and comparative analysis of various SDF assays while primarily focusing on the clinical indications of SDF testing. Importantly, we report four clinical cases where SDF testing had played a significant role in improving fertility outcome. In light of these clinical case reports and recent scientific evidence, this review provides expert recommendations on SDF testing and examines the advantages and drawbacks of the clinical utility of SDF testing using Strength-Weaknesses-Opportunities-Threats (SWOT) analysis.
Description
Citation
Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho CL, Henkel R, Finelli R, Leisegang K, Sengupta P, Barbarosie C, Parekh N, Alves MG, Ko E, Arafa M, Tadros N, Ramasamy R, Kavoussi P, Ambar R, Kuchakulla M, Robert KA, Iovine C, Durairajanayagam D, Jindal S, Shah R. Sperm DNA Fragmentation: A New Guideline for Clinicians. World J Mens Health. 2020 Oct;38(4):412-471. doi: 10.5534/wjmh.200128. Epub 2020 Aug 6. PMID: 32777871; PMCID: PMC7502318.
Publisher
The world journal of men's health