Pros and cons of sperm DNA fragmentation testing: weighing the evidence

Conventional semen parameters are poor predictors of reproductive outcomes, and do not reliably discriminate between fertile and infertile men (1,2). A growing body of evidence suggests that markers of sperm DNA integrity may help differentiate fertile from infertile men, but the clinical value of sperm DNA fragmentation testing remains a matter of debate (3). Although guidelines and best practice statements published by the American Urological Association (AUA), European Association of Urology (EAU) and the American Society of Reproductive Medicine (ASRM) all acknowledge the potential contribution of sperm DNA fragmentation to male factor infertility, they do not recommend the routine use of sperm DNA integrity tests in the evaluation and treatment of infertile couples (4-6).