Clinical utility of sperm DNA fragmentation testing: a requisite to infertility practice

Conventional semen analysis is the routine test performed during the evaluation of a couple’s fertility status. The test is cost-effective and easy to perform and at the same time provides essential information on quantitative semen parameters such as semen volume, sperm motility, concentration, viability and morphology. Most practitioners consider a male partner normal or abnormal merely looking at a semen report. Notwithstanding that a semen analysis can provide significant information on sperm fertility parameters as predictive for fertilization; it does not forecast sperm functional and qualitative defects such as sperm DNA integrity, oxidative stress and antisperm antibodies (1,2). It also makes decision making difficult for the providers in certain clinical situations because of it’s inherit variability (3). Further, the advent of assisted reproductive technology (ART) has revolutionized the infertility treatment by offering, classic In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) in patients with abnormal semen parameters (4). On the other hand failed Intra Uterine Insemination (IUI), IVF/ICSI cycles and pregnancy loss have been reported in cases where semen parameters were normal (4,5). Additionally, the limitations of conventional semen analysis are extended into unexplained infertility cases where men had normal sperm parameters (6,7).