Year: 2020
Type: review
Abstract: Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations. This article provides an overview of SDF types, origin and comparative analysis of various SDF assays while primarily focusing on the clinical indications of SDF testing. Importantly, we report four clinical cases where SDF testing had played a significant role in improving fertility outcome. In light of these clinical case reports and recent scientific evidence, this review provides expert recommendations on SDF testing and examines the advantages and drawbacks of the clinical utility of SDF testing using Strength-Weaknesses-Opportunities-Threats (SWOT) analysis.
DOI: 10.5534/wjmh.200128
Authors: Ashok Agarwal, Ahmad Majzoub, Saradha Baskaran, Manesh Kumar Panner Selvam, Chak Lam Cho, Ralf Henkel, Renata Finelli, Kristian Leisegang, Pallav Sengupta, Catalina Barbarosie, Neel Parekh, Marco G. Alves, Edmund Ko, Mohamed Arafa, Nicholas Tadros, Ranjith Ramasamy, Parviz Kavoussi, Rafael Ambar, Manish Kuchakulla, Kathy Amy Robert, Concetta Iovine, Damayanthi Durairajanayagam, Sunil Jindal, Rupin Shah
Institutions: Cleveland Clinic, Weill Cornell Medical College in Qatar, Weill Cornell Medicine, Hamad Medical Corporation, Union Hospital, Chinese University of Hong Kong, Imperial College London, University of the Western Cape, Mahsa University, University of Bucharest, Universidade do Porto, Instituto de Ciências Biomédicas Albel Salazar, Loma Linda University, Cairo University, SIU Medicine, University of Miami, Faculdade de Medicina do ABC, University of Campania "Luigi Vanvitelli", Universiti Teknologi MARA, Lilavati Hospital & Research Centre
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Awards: G3140052664, G7273688554
OpenAlex ID: W3048835988