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Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations.
Sandro C Esteves1,2,3, Armand Zini4, Robert Matthew Coward5,6
1ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.
Andrologia
|October 27, 2020
Summary
This study provides 41 recommendations on sperm DNA fragmentation (SDF) testing and management for male infertility. It offers guidance on best practices and strategies to address SDF-related infertility, despite moderate to low evidence quality.
Area of Science:
- Reproductive Medicine
- Andrology
- Genetics
Background:
- Sperm DNA fragmentation (SDF) is implicated in various male infertility scenarios.
- Advances in SDF testing necessitate updated clinical guidelines.
- Evidence quality supporting current recommendations is often moderate to low.
Purpose of the Study:
- To summarize evidence on SDF impact in clinical infertility.
- To provide recommendations on SDF testing and management.
- To identify research gaps and stimulate future investigation.
Main Methods:
- Systematic review of evidence concerning SDF.
- Formulation of 41 clinical recommendations.
- Consideration of diverse clinical scenarios and technical aspects of SDF testing.
Main Results:
- 13 recommendations focus on technical SDF testing aspects (pre-analytical, thresholds, interpretation).
- 28 recommendations address indications for SDF testing and clinical management.
- Guidance provided for scenarios including varicocele, unexplained infertility, and assisted reproduction.
Conclusions:
- The guideline offers clinicians advice on best practices for SDF testing.
- Recommendations are provided for managing SDF-related infertility based on available evidence.
- Future research directions are highlighted to address knowledge gaps.
