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Review
. 2024 Jun 1;28(2):306-319.
doi: 10.5935/1518-0557.20230076.

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

Syed Waseem Andrabi  1 , Anam Ara  2 , Ankur Saharan  3 , Mir Jaffar  4 , Nivita Gugnani  5 , Sandro C Esteves  6   7   8
Affiliations
Review

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

Syed Waseem Andrabi et al. JBRA Assist Reprod. .

Abstract

Male infertility is a great matter of concern as out of 15% of infertile couples in the reproductive age, about 40% are contributed by male factors alone. For DNA condensation during spermatogenesis, constrained DNA nicking is required, which if increased beyond certain level results in infertility in men. High sperm DNA Fragmentation (SDF) majorly contributes to male infertility and its association with regards to poor natural conception and assisted reproductive technology (ART) outcomes is equivocal. Apoptosis, protamination failure and the excess of reactive oxygen species (ROS) are considered to be the main causes of SDF. It's testing came into existence because of the limitations of the conventional methods in explaining infertility in normozoospermic infertile individuals. Over the past 25 years, SDF's several testing strategies have been proposed to diagnose the aetiology of infertility. Various treatments combined with sperm selection techniques are being used alone or in combination to reduce DNA fragmentation index (DFI) and obtain spermatozoa with high quality chromatin for assisted reproduction. This review summarises SDF's main causes, its impact on fertility and clinical outcomes in assisted reproduction, the need to perform test, testing procedures, and the treatment strategies.

Keywords: DNA fragmentation; assisted reproductive techniques; male infertility; reproductive biology; sperm.

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Figures

Figure 1
Figure 1
SDF causes, tests and treatments (Abbreviations used: SCSA-Sperm chromatin structure assay, SCD-Sperm Chromatin Dispersion IUI-Intrauterine Insemination, IVF-In Vitro Fertilization, ICSI-Intracytoplasmic Sperm Injection).
Figure 2
Figure 2
Flow chart illustrating the study selection criteria.
Figure 3
Figure 3
Equations illustrating the generation of ROS.
Figure 4
Figure 4
Depending on the severity of SDF, treatment can be done.
See this image and copyright information in PMC

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