Clinical utility of sperm DNA fragmentation testing: concise practice recommendations.

Area of Science:

• Reproductive Medicine
• Genetics
• Clinical Diagnostics

Background:

• Sperm DNA integrity is vital for successful human reproduction.
• High sperm DNA fragmentation (SDF) negatively impacts natural and assisted reproductive technology (ART) outcomes.
• The clinical indications for SDF testing remain less defined despite its known impact.

Discussion:

• This practice recommendation summarizes current evidence on the clinical utility of SDF testing.
• It explores SDF testing's role in specific patient groups, including varicocelectomy candidates, couples with recurrent pregnancy loss, unexplained infertility, and failed ART.
• Expert panel recommendations with evidence levels are provided for each clinical scenario.

Key Insights:

• SDF testing offers valuable insights into male infertility beyond traditional semen parameters.
• Evidence supports SDF testing in selected cases of recurrent pregnancy loss and unexplained infertility.
• SDF testing can guide treatment decisions, potentially improving reproductive outcomes.

Outlook:

• Further research is needed to refine SDF testing protocols and establish universal clinical guidelines.
• Integrating SDF testing into routine infertility workups may enhance personalized reproductive medicine.
• Future studies should focus on the impact of SDF levels on specific ART techniques and live birth rates.