REVIEW  HOT TOPICS IN REPRODUCTIVE BIOLOGY: THE STATE OF THE ART OF ART FOR REPRODUCTIVE PROFESSIONALS Free access

Panminerva Medica 2023 June;65(2):135-47

DOI: 10.23736/S0031-0808.23.04836-X

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

Sperm DNA fragmentation test: usefulness in assessing male fertility and assisted reproductive technology outcomes

Evangelini EVGENI ¹, Marjan SABBAGHIAN ^{2, 3}, Ramadan SALEH ^{3 ,4}, Murat GÜL ^{3, 5}, Paraskevi VOGIATZI ^{3, 6}, Damayanthi DURAIRAJANAYAGAM ^{3, 7}, Sunil JINDAL ^{3, 8}, Lodovico PARMEGIANI ⁹, Florence BOITRELLE ^{3, 10, 11}, Giovanni COLPI ^{3, 12}, Ashok AGARWAL ^{3, 13} ✉

¹ Cryogonia Cryopreservation Bank, Athens, Greece; ² Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, AECR, Tehran, Iran; ³ Global Andrology Forum, Morelands Hills, OH, USA; ⁴ Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt; ⁵ Department of Urology, Selck University School of Medicine, Konya, Türkiye; ⁶ Andromed Health and Reproduction, Fertility and Reproductive Health Diagnostic Center, Athens, Greece; ⁷ Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia; ⁸ Department of Andrology and Reproductive Medicine, Jindal Hospital and Fertility Center, Meerut, India; ⁹ Next Fertility GynePro - NextClinics International, Bologna, Italy; ¹⁰ Department of Reproductive Biology, Fertility Preservation, Andrology, Poissy Hospital, Poissy, France; ¹¹ Department BREED Biology of Reproduction, Epigenetics, Environment, Development, INRAe, UVSQ, ENVA, Jouy en Josas, France; ¹² Next Fertility Procrea, Lugano, Switzerland; ¹³ Cleveland Clinic, Cleveland, OH, USA

Male infertility is attributed to multiple factors including high levels of sperm DNA fragmentation (SDF). Conventional semen analysis continues to be the gold standard for diagnosis of male factor infertility around the world. However, the limitations of basic semen analysis have prompted the search for complementary assessments of sperm function and integrity. Sperm DNA fragmentation assays (direct or indirect) are emerging as important diagnostic tools in male infertility workups, and have been advocated for use in infertile couples for a variety of reasons. While a controlled degree of DNA nicking is required for appropriate DNA compaction, excessive fragmentation of sperm DNA is linked to impaired male fertility potential, decreased fertilization, poor embryo quality, recurrent pregnancy loss, and failure of assisted reproductive technology procedures. However, there is an ongoing debate regarding whether or not to employ SDF as a routine test for male infertility. This review compiles up-to-date information regarding the pathophysiology of SDF, the currently available SDF tests, and the role of SDF tests in natural and assisted conception conditions.

KEY WORDS: Reproductive techniques, assisted; Infertility, male; Pregnancy; Spermatozoa; DNA fragmentation