Implications of ejaculatory sperm DNA fragmentation on male infertility management

Latest guidelines from the World Health Organization (WHO) on the laboratory examination of human semen still focus on traditional semen analysis (SA) (1). However, the more recent recommendations from the major societies in the andrology field suggest to utilize new functional tests in certain conditions (2,3). Although the American Urological Association (AUA) best practice statement (2) and the joint guideline course of European Academy of Andrology (EAA) and the European Association of Urology (EAU) on clinical andrology (2) stated that routine use of ejaculatory sperm DNA fragmentation (SDF) in all infertile couples is not supported by current literature, there is a general consensus that some of the infertile couples may benefit from sperm DNA integrity evaluation. Abnormal SDF, is characterized by more than 15% (fair sperm DNA integrity) to more than 30% (poor sperm integrity) fragmented DNA in ejaculatory sperm (4).