Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendationsopen access
- Authors
- Agarwal, Ashok; Farkouh, Ala'a; Saleh, Ramadan; Hamoda, Taha Abo-Almagd Abdel-Meguid; Harraz, Ahmed M.; Kavoussi, Parviz; Arafa, Mohame; Salvio, Gianmaria; Rambhatla, Amarnath; Toprak, Tuncay; Gul, Murat; Phuoc, Nguyen HoVinh; Boitrelle, Florence; Birowo, Ponco; Abou Ghayda, Ramy; Cannarella, Rossella; Kuroda, Shinnosuke; Durairajanayagam, Damayanthi; Zini, Armand; Wyns, Christine; Sarikaya, Selcuk; Tremellen, Kelton; Mostafa, Taymour; Sokolakis, Ioannis; Evenson, Donald P.; Honkel, Ral; Zohdy, Wael; Chung, Eric; Ziouziou, Imad; Falcone, Marco; Russo, Giorgio I.; Al-Hashimi, Manaf; Calogero, Aldo E.; Ko, Edmund; Colpi, Giovanni; Lewis, Sheena; Serefoglu, Ege Can; Bahar, Fahmi; Martinez, Marlon; Nguyen, Quang; Ambar, Rafael F.; Bakircioglu, Mustafa Emre; Kandil, Hussein; Mogharabian, Nasser; Sabbaghian, Marjan; Taniguchi, Hisanori; Tsujimura, Akira; Sajadi, Hesamoddin; Ibrahim, Wael; Atmoko, Widi; Vogiatzi, Paraskevi; Gunes, Sezgin; Gilani, Mohammad Ali Sadighi; Roychoudhury, Shubhadeep; Gungor, Nur Dokuzeylul; Hakim, Lukman; Adriansjah, Ricky; Kothari, Priyank; Jindal, Sunil; Amar, Edouard; Jun-Park, Hyun; Long, Tran Quang Tien; Homa, Sheryl; Karthikeyan, Vilvapathy Senguttuvan; Zilaitiene, Birute; Rosas, Israel Maldonado; Marino, Angelo; Pescatori, Edoardo; Ozer, Cevahir; Akhavizadegan, Hamed; Garrido, Nicolas; Busetto, Gian Maria; Adamyan, Aram; Al-Marhoon, Mohamed; Elbardisi, Haitham; Dolati, Parisa; Darbandi, Mahsa; Darbandi, Sara; Balercia, Giancarlo; Pinggera, Germar-Michael; Micic, Sava; Ho, Christopher Chee Kong; Moussa, Mohamad; Preto, Mirko; Zenoaga-Barbarosie, Catalina; Smith, Ryan P.; Kosgi, Raghavender; de la Rosette, Jean; El-Sakka, Ahmed I.; Abumelha, Saad Mohammed; Mierzwa, Tiago Cesar; Ong, Teng Aik; Banihani, Saleem A.; Bowa, Kasonde; Fukuhara, Shinichiro; Boeri, Luca; Danacioglu, Yavuz Onur; Gokalp, Fatih; Selim, Osama Mohamed; Cho, Chak-Lam; Tadros, Nicholas N.; Ugur, Muhammet Rasit; Ozkent, Mehmet Serkan; Chiu, Peter; Kalkanli, Arif; Khalafalla, Kareim; Vishwakarma, Ranjit B.; Finocchi, Federica; Andreadakis, Sotiris; Giulioni, Carlo; Ceker, Gokhan; Ceyhan, Erman; Malhotra, Vineet; Yimaz, Mehmet; Timpano, Massimiliano; Barrett, Trenton L.; Kim, Shannon Hee Kyung; Ahn, Sun-Tae; Giacone, Filippo; Palani, Ayad; Duarsa, Gede Wirya Kusuma; Kadioglu, Ates; Gadda, Franco; Zylbersztejn, Daniel Suslik; Aydos, Kaan; Kulaksiz, Deniz; Gupte, Deepak; Calik, Gokhan; Karna, Keshab Kumar; Drakopoulos, Panagiotis; Baser, Aykut; Kumar, Vijay; Molina, Juan Manuel Corral; Rajmil, Osvaldo; Ferreira, Raphael H.; Leonardi, Sofia; Avoyan, Armen; Sogutdelen, Emrullah; Franco, Giorgio; Ramsay, Jonathan; Ramirez, Liliana; Shah, Rupin
- Issue Date
- Jul-2023
- Publisher
- 대한남성과학회
- Keywords
- Delphi method; DNA fragmentation; Male infertility; Practice guidelines; Sperm; Survey
- Citation
- The World Journal of Men's Health, v.41, no.3, pp 575 - 602
- Pages
- 28
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- The World Journal of Men's Health
- Volume
- 41
- Number
- 3
- Start Page
- 575
- End Page
- 602
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/63596
- DOI
- 10.5534/wjmh.220282
- ISSN
- 2287-4208
2287-4690
- Abstract
- Purpose
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.
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- Appears in
Collections - 2. Clinical Science > Department of Urology > 1. Journal Articles
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