Sperm DNA fragmentation testing: proceed with care

The authors should be commended for their thorough review of DNA fragmentation and the clinical indications for testing. The basic science review of DNA fragmentation, oxidative stress, and its association with male infertility is detailed yet concise. The authors also present clinical scenarios to better illustrate the current role of evaluating sperm DNA fragmentation (SDF) in the infertility specialist’s armamentarium, and describe very convincing theoretical arguments for the potential importance of SDF. However, the clinical role of SDF in the evaluation of men with male factor infertility remains unclear, and several recommendations made in this article do not yet have sufficient clinical data to support its routine use