Practical considerations for DNA fragmentation testing in the management of male fertility

Over the past decade, the importance of DNA fragmentation has matured as more studies suggested a role in the management of male fertility. As a measure of spermatogenic damage from reactive oxygen species (ROS), DNA fragmentation occurs primarily during posttesticular processing through the epididymis (1,2). Given that spermatozoa are exquisitely sensitive to oxidative stress, varicoceles, a known cause of elevated ROS levels, are theorized to be one of the major contributors.