Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines

Ashok Agarwal¹, Ala'a Farkouh², Neel Parekh³, Armand Zini⁴, Mohamed Arafa^{2

5

6}, Hussein Kandil⁷, Nick Tadros⁸, Gian Maria Busetto⁹, Rafael Ambar¹⁰, Sijo Parekattil¹¹, Florence Boitrelle¹², Hassan Sallam¹³, Sunil Jindal¹⁴, Edmund Ko¹⁵, Mara Simopoulou¹⁶, Hyun Jun Park^{17

18}, Mohammad Ali Sadighi¹⁹, Ramadan Saleh²⁰, Jonathan Ramsay²¹, Marlon Martinez²², Haitham Elbardisi^{5

23}, Juan Alvarez²⁴, Giovanni Colpi²⁵, Jaime Gosalvez²⁶, Donald Evenson²⁷, Rupin Shah²⁸

Affiliations

¹ American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA. agarwaa@ccf.org.
² American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
³ Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
⁴ Department of Surgery, McGill University, Montreal, QC, Canada.
⁵ Department of Urology, Hamad Medical Corporation, Doha, Qatar.
⁶ Department of Andrology, Cairo University, Giza, Egypt.
⁷ Fakih IVF Fertility Center, Abu Dhabi, UAE.
⁸ Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
⁹ Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy.
¹⁰ Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil.
¹¹ Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA.
¹² Biologie de la Reproduction - Preservation de la fertilite' - Andrologie - CECOS CHI de Poissy Saint Germain en Laye Universite' Paris, Saclay, France.
¹³ Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt.
¹⁴ Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.
¹⁵ Department of Urology, Loma Linda University Health, Loma Linda, CA, USA.
¹⁶ Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹⁷ Department of Urology, Pusan National University School of Medicine, Busan, Korea.
¹⁸ Medical Research Institute of Pusan National University Hospital, Busan, Korea.
¹⁹ Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
²⁰ Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.
²¹ Department of Andrology, Hammersmith Hospital, London, UK.
²² Section of Urology, University of Santo Tomas Hospital, Manila, Philippines.
²³ Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar.
²⁴ Centro Androgen, La Coruña, Spain and Harvard Medical School, Boston, MA, USA.
²⁵ Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland.
²⁶ Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain.
²⁷ SCSA Diagnostics, Brookings, SD, USA.
²⁸ Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.

PMID: 33988000
PMCID: PMC8761233
DOI: 10.5534/wjmh.210056

Review

Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines

Ashok Agarwal et al. World J Mens Health. 2022 Jan.

. 2022 Jan;40(1):30-37.

doi: 10.5534/wjmh.210056. Epub 2021 Apr 21.

Authors

Affiliations

¹ American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA. agarwaa@ccf.org.
² American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
³ Department of Urology, Cleveland Clinic, Cleveland, OH, USA.
⁴ Department of Surgery, McGill University, Montreal, QC, Canada.
⁵ Department of Urology, Hamad Medical Corporation, Doha, Qatar.
⁶ Department of Andrology, Cairo University, Giza, Egypt.
⁷ Fakih IVF Fertility Center, Abu Dhabi, UAE.
⁸ Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.
⁹ Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy.
¹⁰ Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil.
¹¹ Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA.
¹² Biologie de la Reproduction - Preservation de la fertilite' - Andrologie - CECOS CHI de Poissy Saint Germain en Laye Universite' Paris, Saclay, France.
¹³ Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt.
¹⁴ Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.
¹⁵ Department of Urology, Loma Linda University Health, Loma Linda, CA, USA.
¹⁶ Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹⁷ Department of Urology, Pusan National University School of Medicine, Busan, Korea.
¹⁸ Medical Research Institute of Pusan National University Hospital, Busan, Korea.
¹⁹ Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
²⁰ Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.
²¹ Department of Andrology, Hammersmith Hospital, London, UK.
²² Section of Urology, University of Santo Tomas Hospital, Manila, Philippines.
²³ Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar.
²⁴ Centro Androgen, La Coruña, Spain and Harvard Medical School, Boston, MA, USA.
²⁵ Andrology and IVF Unit, Procrea Institute, Lugano, Switzerland.
²⁶ Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain.
²⁷ SCSA Diagnostics, Brookings, SD, USA.
²⁸ Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.

PMID: 33988000
PMCID: PMC8761233
DOI: 10.5534/wjmh.210056

Abstract

Sperm DNA fragmentation (SDF) is implicated in male infertility and adverse reproductive outcomes. With the publication of many studies regarding the etiologies and contributors to SDF, as well as the effects of SDF, guidelines are necessary to aid clinicians in the application of SDF for male fertility evaluation. Two recent clinical practice guidelines were published by Agarwal et al and Esteves et al. In this article, we have evaluated and compared both guidelines. We have found fairly similar recommendations between the two guidelines and have also highlighted the differences between them. Finally, we have summarized and combined the best practice recommendations from both guidelines.

Keywords: DNA fragmentation; Male infertility; Oxidative stress; Practice guidelines as topic; Reproductive techniques, assisted.

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Conflict of interest statement

The authors have nothing to disclose.

References

1. González-Marín C, Gosálvez J, Roy R. Types, causes, detection and repair of DNA fragmentation in animal and human sperm cells. Int J Mol Sci. 2012;13:14026–14052. - PMC - PubMed
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1. Evenson DP, Jost LK, Marshall D, Zinaman MJ, Clegg E, Purvis K, et al. Utility of the sperm chromatin structure assay as a diagnostic and prognostic tool in the human fertility clinic. Hum Reprod. 1999;14:1039–1049. - PubMed
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1. Chen Q, Zhao JY, Xue X, Zhu GX. The association between sperm DNA fragmentation and reproductive outcomes following intrauterine insemination, a meta analysis. Reprod Toxicol. 2019;86:50–55. - PubMed

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Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines

Affiliations

Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

LinkOut - more resources

Full Text Sources

Other Literature Sources