Commentary on clinical utility of sperm DNA fragmentation testing

Approximately 15% of couples are unable to conceive after one year of unprotected intercourse and a male factor is solely responsible or contributory in approximately 50% (1). Of these couples up to 30% may have unexplained infertility with a normal semen analysis and no obvious reason for their inability to conceive (2,3). Semen analyses alone are difficult to use in clinical decision making due to their inherent variability (4). This limitation extends into a variety of clinical situations including assistive reproductive technique (ART) failure, unexplained infertility in the setting of normal bulk semen parameters, and patients with low grade clinical varicoceles.