Sperm DNA Fragmentation Testing in Infertility

Sperm DNA fragmentation (SDF) refers to breaks or damage in the DNA strand (s) in sperm cells, which can lead to an increased risk of male infertility. The extent of DNA fragmentation can vary widely, from mild to severe, and can be caused by a number of factors, including oxidative stress (OS), environmental toxins, and genetic abnormalities. SDF testing can help identify potential fertility issues even in men who have normal semen parameters or unexplained infertility. Moreover, SDF testing can also help predict the success of certain fertility treatments. For example, men with high levels of DNA fragmentation may be less likely to have success with in vitro fertilization (IVF) but may benefit from intracytoplasmic sperm injection (ICSI). SDF analysis is a relatively new field of study, and there are several different methods used to measure sperm DNA fragmentation. Each test has its advantages and limitations, and the results may vary depending on the specific circumstances of the individual being tested. At a time of constantly emerging ideas, policies, and protocols for SDF testing in male infertility, it is important to have an updated understanding of the contemporary SDF tests to ensure that research, diagnoses, and treatment are based on the latest concepts in this field. The present chapter describes updated concepts on SDF and the significance of SDF testing to better identify the underlying mechanisms of male infertility, develop tailored male infertility treatment, predict treatment success, and reduce the risk of unsuccessful pregnancy and ART outcomes.