Integrating surgical and clinical andrology is essential to improve the quality of care delivered to infertile couples

Drs. Yovich and Keane’s commentary (1) about the recently published clinical practice guidelines for sperm DNA fragmentation (SDF) testing based on clinical scenarios (2) is an excellent piece of writing. The authors commence by acknowledging the importance of male infertility evaluation and integration of clinical and laboratory andrology in the modern workup of infertile couples. However, they pointed out that current practice values the male factor only if semen analysis is severely abnormal in contrast to the usual comprehensive female infertility evaluation.