Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations
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Authors
Esteves, Sandro C
Zini, Armand
Coward, Robert Matthew
Evenson, Donald P
Gosálvez, Jaime
Lewis, Sheena E M
Sharma, Rakesh
Humaidan, Peter
Issue Date
2021-03
Type
Article
Language
en_US
Keywords
Assisted Reproductive Technology , Male Infertility , Practice Guideline , Semen Analysis , Sperm DNA Fragmentation
Alternative Title
Abstract
We herein summarise the evidence concerning the impact of sperm DNA fragmentation in various clinical infertility scenarios and the advances on sperm DNA fragmentation tests. The collected evidence was used to formulate 41 recommendations. Of these, 13 recommendations concern technical aspects of sperm DNA fragmentation testing, including pre-analytical information, clinical thresholds and interpretation of results. The remaining 28 recommendations relate to indications for sperm DNA fragmentation testing and clinical management. Clinical scenarios like varicocele, unexplained infertility, idiopathic infertility, recurrent pregnancy loss, intrauterine insemination, in vitro fertilisation/intracytoplasmic sperm injection, fertility counselling for men with infertility risk factors and sperm cryopreservation have been contemplated. The bulk evidence supporting the recommendations has increased in recent years, but it is still of moderate to low quality. This guideline provides clinicians with advice on best practices in sperm DNA fragmentation testing. Also, recommendations are provided on possible management strategies to overcome infertility related to sperm DNA fragmentation, based on the best available evidence. Lastly, we identified gaps in knowledge and opportunities for research and elaborated a list of recommendations to stimulate further investigation.
Description
Citation
Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SEM, Sharma R, Humaidan P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia. 2021 Mar;53(2):e13874. doi: 10.1111/and.13874. Epub 2020 Oct 27. PMID: 33108829; PMCID: PMC7988559.
Publisher
Andrologia