The complex nature of the sperm DNA damage process
Dr. Menezo and colleagues (1), in their commentary regarding the practice recommendations for sperm DNA fragmentation (SDF) testing based on clinical scenarios by Agarwal et al. (2), pointed to the importance of distinguishing between SDF and sperm nucleus decondensation (SND) as these are independent processes. The authors reasoned that while the oocyte has a limited capacity to repair DNA strand breaks, it is poorly equipped to repair nucleus decondensation. They go further by listing conditions more likely to be associated with one (e.g., lifestyle factors and SDF) or the other (e.g., IVF/ICSI failure due to early embryo arrest and nucleus decondensation) and the tests best suited to measure SND.