Sperm DNA fragmentation in clinical practice

We value the comments written by Dr. Benagiano on the “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” (1). The author has pointed out the controversies surrounding the diagnostic potential of conventional semen parameters and tests of sperm DNA fragmentation (SDF) in cases of recurrent pregnancy loss and in predicting the outcomes of assisted reproductive techniques (ART). He concluded that SDF testing is a useful tool to assess chromatin integrity and understand the origins and mechanisms of DNA damage, however, its clinical utility is somehow hindered by the lack of well-designed studies and therefore is not widely accepted.