Clinical implication of DNA fragmentation in male infertility

Recently, sperm DNA fragmentation (SDF) has been recognized as an important marker of sperm quality that can be used as a predictive factor for fertility in men. Although some controversies exist regarding the role of SDF in infertility, the fact remains that semen from infertile men possess a higher level of SDF than fertile controls (1,2). Elevated SDF may not only contribute to higher rates of failed fertilizations and spontaneous pregnancy loss, but it can also affect assisted reproductive techniques (ART) outcomes in terms of oocyte fertilization, embryo quality, clinical pregnancy and live birth rate. However, controversy still exists regarding the association between SDF and the outcomes of intracytoplasmic sperm injection (ICSI) (3,4).