Sperm DNA fragmentation: a need to fully address the impact on fertility outcomes

Reflections

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VOLUME 116, ISSUE 1, P69-70

Author:

Steven D. Spandorfer, M.D.

Abstract:

Reflections on "Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I" by Schlegel et al.

Read the full text here. 

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. 

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Go to the profile of Pandiyan  Natarajan
about 2 months ago

Spermatozoa DNA Fragmentation Tests: Much ado about Nothing.

I enjoyed reading the Reflections on Spermatozoa DNA Fragmentation.

Increased Spermatozoa DNA Fragmentation have been unjustifiably implicated in several conditions like Implantation Failure, Recurrent Miscarriage, Failed Fertilization, Failed IVF and Failed ICSI cycles with little or no evidence. ASRM has repeatedly emphasized that Spermatozoa DNA Fragmentation Tests are not indicated as a routine ( 1, 2 ). Are they indicated under special circumstances is debatable.

Several publications have indicated that smoking, obesity, urinary tract infections may all increase DNA Fragmentation and cause Infertility.  If that were to be true, the underlying cause needs treatment and not the increased DNA fragmentation. Do Not Shoot the Messenger.

We have clearly explained in our earlier publication that Spermatozoa DNA Fragmentation Tests would be a very useful research tool, but has no clinical applications now. (3 ).

1. The clinical utility of sperm DNA integrity testing: a guideline. 

2. Diagnosis and Treatment of Infertility in Men: AUA/ ASRM Guideline. AUA/ASRM Guideline. October 2020.

3. A perspective on sperm DNA fragmentation. Natarajan Pandiyan, Radha Pandiyan, D. Ramesh Raja.

Pandiyan N, Pandiyan R, Raja DR. A perspective on sperm DNA fragmentation. Transl Androl Urol 2017;6(Suppl 4):S661-S664. doi: 10.21037/tau.2017.03.84 

doi: 10.21037/tau.2017.03.84

Professor Dr Pandiyan Natarajan,

Professor and Head of the Department of Andrology and Reproductive Medicine,

 Chettinad Super Speciality Hospital,

Chettinad Academy of Research and Education,

Kelambakkam, Chennai,

Tamil Nadu, India- 603103.