Sperm DNA Fragmentation: causes, evaluation and management in male infertility

Area of Science:

• Reproductive Medicine
• Genetics
• Andrology

Background:

• Male infertility affects 40% of infertile couples, with sperm DNA fragmentation (SDF) being a key factor.
• High SDF levels are linked to poor natural conception and assisted reproductive technology (ART) outcomes, though associations are debated.
• Causes of SDF include apoptosis, protamination failure, and excess reactive oxygen species (ROS).

Purpose of the Study:

• To review the causes, impact, and diagnostic strategies for sperm DNA fragmentation (SDF).
• To explore the role of SDF testing in diagnosing male infertility, especially in normozoospermic individuals.
• To summarize current and emerging treatment strategies for reducing SDF and improving ART success.

Main Methods:

• Literature review of studies on sperm DNA fragmentation (SDF) over the past 25 years.
• Analysis of various testing strategies for diagnosing SDF and its aetiology.
• Evaluation of treatment approaches, including sperm selection techniques, to reduce DNA fragmentation index (DFI).

Main Results:

• SDF testing addresses limitations of conventional methods in unexplained infertility cases.
• Multiple SDF testing strategies have been developed to diagnose infertility causes.
• Treatments aim to reduce DFI and enhance sperm chromatin quality for improved ART outcomes.

Conclusions:

• Sperm DNA fragmentation (SDF) is a critical factor in male infertility.
• SDF testing is essential for diagnosing specific infertility causes and guiding treatment.
• Effective management of SDF can improve natural conception and ART success rates.