Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisReviewForskningpeer review


  • Sandro C Esteves, Andrology and Human Reproduction Clinic, Campinas State University, UNICAMP
  • ,
  • Armand Zini, McGill Univ, McGill University, McGill Space Inst
  • ,
  • Robert Matthew Coward, Univ North Carolina Chapel Hill, University of North Carolina, University of North Carolina Chapel Hill, University of North Carolina School of Medicine, Dept Phys & Astron
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  • Donald P Evenson, SCSA Diagnostics
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  • Jaime Gosálvez, Psychiatric Genetics Unit
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  • Sheena E M Lewis, Queens Univ Belfast, Queens University Belfast, Ctr Publ Hlth
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  • Rakesh Sharma, American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
  • ,
  • Peter Humaidan

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 practice 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 concerning sperm DNA fragmentation testing and management of sperm DNA fragmentation-related infertility conditions.

Antal sider41
StatusUdgivet - mar. 2021

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