Commentary: the value of testing sperm DNA fragmentation in infertile men
Over the past 20 years, the necessity and usefulness of clinically testing for DNA fragmentation in spermatozoa has been increasingly researched and debated. Studies have shown that sperm with impaired DNA integrity are related to prolonged time to pregnancy, significantly lower conception rates both naturally and after intrauterine insemination (IUI), as well as increased pregnancy loss. High levels of sperm DNA damage have also been linked to poor integrity of the embryonic genome and impaired embryo development. However, both scientists and clinicians remain divided as to whether the potential information that the measurement of immature chromatin or fragmented DNA in spermatozoa may offer, in addition to that provided by routine semen analysis, is actually relevant in a clinical setting. In a recent paper, a select team of authorities in the field of male infertility recommended a practice guideline pertaining to the clinical value of sperm DNA fragmentation assessment (1). The group employed an evidence-based approach to describe clinical scenarios that most warranted sperm DNA testing as well as the management of patients with high sperm DNA fragmentation.