Evidence map›Paper›PMID 29713533›Full record

ArticleArab journal of urology2018

Role of sperm DNA fragmentation in male factor infertility: A systematic review.

Chak-Lam Cho, Ashok Agarwal

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arab journal of urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Meta-correlation of Sperm Morphology and DNA Fragmentation Index.Reproductive sciences (Thousand Oaks, Calif.) · 2025
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  12. Sperm selection for assisted reproductive technology: do we have a winner?Journal of assisted reproduction and genetics · 2025
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  14. Article
  15. Avocado (Toxicology research · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Chak-Lam ChoDivision of Urology, Department of Surgery, Kwong Wah Hospital, Yaumatei, Hong Kong.
Ashok AgarwalAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo summarise the latest evidence on the role of sperm DNA fragmentation (SDF) in male factor infertility, as SDF has been emerging as a valuable tool for male infertility evaluation.

methodsA search of PubMed was conducted using the keywords 'sperm DNA fragmentation' and 'male infertility'. Studies in languages other than English were excluded. All identified studies were screened and clinical studies in humans were included.

resultsIn all, 150 articles were included for analysis. Current evidence supports the association between high SDF and poor reproductive outcomes for natural conception and intrauterine insemination. Although the relationship between high SDF and in vitro fertilisation and intracytoplasmic sperm injection is less clear, the negative implication of high SDF on pregnancy loss is evident. Various treatment strategies have been attempted with varying success. The predictive value of SDF testing on outcomes of natural pregnancy and assisted reproduction illustrates its value in clinical practice.

conclusionThe significant role of SDF in male factor infertility is supported by current evidence. The beneficial role of SDF testing in selection of varicocelectomy candidates, evaluation of patients with unexplained infertility and recurrent pregnancy loss, selection of the most appropriate assisted reproductive technique with highest success rate for infertile couples, and assessment of infertile men with modifiable lifestyle factors or gonadotoxin exposure has been recently proposed.

Indexed as

ART, assisted reproductive technologyASRM, American Society for Reproductive MedicineAssisted reproductive technology (ART)Comet, single cell gel electrophoresis assayEAU, European Association of UrologyICSI, intracytoplasmic sperm injectionIMSI, intracytoplasmic morphologically selected sperm injectionIUI, intrauterine inseminationIVF, in vitro fertilisationMACS, magnetic cell sortingMale infertilityOR, odds ratioPICSI, physiological ICSI with hyaluronic acid binding assayROS, reactive oxygen speciesRR, relative riskSCD, sperm chromatin dispersionSCSA, sperm chromatin structure assaySDF, sperm DNA fragmentationSperm DNA fragmentation (SDF)TUNEL, terminal deoxynucleotidyl transferase dUTP nick end labelling

Identifiers

PMID29713533
PMCPMC5922225

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.