The value of sperm DNA fragmentation testing in real-life clinical presentations

We want to congratulate the authors for their commentary on “clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios“”, by Agarwal et al. (1). The authors have given a constructive critique of our article praising its structure and writing style, though they expressed their reservation on the ability of clinical scenarios to mimic real life case presentations. After highlighting the challenges that are often faced in any medical practice when dealing with a diagnostic modality that has equivocal clinical applicability, Lynne and Brackett further pointed out some of the difficulties that are specific to sperm DNA fragmentation (SDF) testing. They expressed their concern regarding the recommendation of SDF testing for patients with lifestyle risk factors. Furthermore, they rightly questioned the clinical utility of SDF in patients with severe oligozoospermia.