Technical aspects and clinical limitations of 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.authorid0000-0002-9976-9666
dc.contributor.authorAgarwal, Ashok
dc.contributor.authorFarkouh, Ala’a
dc.contributor.authorSaleh, Ramadan
dc.contributor.authorHamoda, Taha Abo-Almagd Abdel-Meguid
dc.contributor.authorSalvio, Gianmaria
dc.contributor.authorBoitrelle, Florence
dc.contributor.authorLin, Haocheng
dc.contributor.authorShah, Rupin
dc.date.accessioned2023-10-23T11:15:13Z
dc.date.available2023-10-23T11:15:13Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractPurpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial.
dc.identifier.citationAgarwal, A., Farkouh, A., Saleh, R., Hamoda, T. A., Salvio, G., Boitrelle, F. ... Shah, R. (2023). Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations. World Journal of Men's Health, 41. https://doi.org/10.5534/wjmh.230076
dc.identifier.doi10.5534/wjmh.230076
dc.identifier.issn2287-4208
dc.identifier.issn2287-4690
dc.identifier.pmid37635341
dc.identifier.scopus2-s2.0-85173813215
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.5534/wjmh.230076
dc.identifier.urihttps://hdl.handle.net/20.500.12511/11625
dc.identifier.volume41
dc.identifier.wos001063965600001en_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.subjectDiagnostic Test
dc.subjectDNA Fragmentation
dc.subjectInfertility
dc.subjectMale
dc.subjectSurvey
dc.titleTechnical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: A global survey, current guidelines, and expert recommendations
dc.typeArticle

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