Controversy and consensus on indications for sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations

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dc.authorid0000-0002-6308-1763
dc.contributor.authorAgarwal, Ashok
dc.contributor.authorFarkouh, Ala'a
dc.contributor.authorSaleh, Ramadan
dc.contributor.authorHamoda, Taha Abo-Almagd Abdel-Meguid
dc.contributor.authorHarraz, Ahmed M.
dc.contributor.authorKavoussi, Parviz
dc.contributor.authorArafa, Mohamed
dc.contributor.authorPalani, Ayad
dc.date.accessioned2023-05-30T06:10:24Z
dc.date.available2023-05-30T06:10:24Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractPurpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.
dc.identifier.citationAgarwal, A., Farkouh, A., Saleh, R., Hamoda, T., Harraz, A. M., Kavoussi, P. ... Palani, A. (2023). Controversy and consensus on indications for sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations. World Journal of Men's Health, 41(3), 575-602. https://doi.org/10.5534/wjmh.220282
dc.identifier.doi10.5534/wjmh.220282
dc.identifier.endpage602
dc.identifier.issn2287-4208
dc.identifier.issue3
dc.identifier.pmid37118960
dc.identifier.scopus2-s2.0-85159180302
dc.identifier.scopusqualityQ1
dc.identifier.startpage575
dc.identifier.urihttps://doi.org/10.5534/wjmh.220282
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10990
dc.identifier.volume41
dc.identifier.wos001081903000008en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorde la Rosette, Jean J. M. C. H.
dc.institutionauthorÇalık, Gökhan
dc.language.isoen
dc.publisherKorean Society for Sexual Medicine and Andrology
dc.relation.ispartofWorld Journal of Men's Healthen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution-NonCommercial 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/*
dc.subjectDelphi Method
dc.subjectDNA Fragmentation
dc.subjectMale Infertility
dc.subjectPractice Guidelines
dc.subjectSperm
dc.subjectSurvey
dc.titleControversy and consensus on indications for sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations
dc.typeArticle

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