Evidence map›Paper›PMID 32777871›Full record

ReviewThe world journal of men's health2020

Sperm DNA Fragmentation: A New Guideline for Clinicians.

Ashok Agarwal, Ahmad Majzoub, Saradha Baskaran, Manesh Kumar Panner Selvam, Chak Lam Cho, Ralf Henkel, Renata Finelli, Kristian Leisegang, Pallav Sengupta, Catalina Barbarosie and 14 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The world journal of men's health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 172 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
172citing papers in PubMed, 3 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

172 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Meta-correlation of Sperm Morphology and DNA Fragmentation Index.Reproductive sciences (Thousand Oaks, Calif.) · 2025
    Pooled it
  4. Trial
  5. Trial
  6. Article
  7. Article
  8. Review
  9. Review
  10. Association Between Leukocytospermia and Varicocele in Patients With Infertility.American journal of reproductive immunology (New York, N.Y. : 1989) · 2026
    Review
  11. Article
  12. Review
  13. Article
  14. Observational
  15. Article
  16. Review
  17. Review
  18. Observational
  19. Article
  20. Review

112 more citing papers are in PubMed but not listed here.

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

24 authors.

Ashok AgarwalAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA. agarwaa@ccf.org.ORCID https://orcid.org/0000-0003-0585-1026
Ahmad MajzoubDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID https://orcid.org/0000-0001-7423-6241
Saradha BaskaranAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-4499-8680
Manesh Kumar Panner SelvamAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-9120-2278
Chak Lam ChoDepartment of Surgery, Union Hospital, Hong Kong.ORCID https://orcid.org/0000-0003-2520-6833
Ralf HenkelDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.ORCID https://orcid.org/0000-0003-1128-2982
Renata FinelliAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-5926-6407
Kristian LeisegangSchool of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa.ORCID https://orcid.org/0000-0002-3003-8048
Pallav SenguptaDepartment of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Malaysia.ORCID https://orcid.org/0000-0002-1928-5048
Catalina BarbarosieDepartment of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania.ORCID https://orcid.org/0000-0002-2854-9834
Neel ParekhDepartment of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-6218-9254
Marco G AlvesDepartment of Microscopy, Laboratory of Cell Biology & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.ORCID https://orcid.org/0000-0001-7635-783X
Edmund KoDepartment of Urology, Loma Linda University, Loma Linda, CA, USA.ORCID https://orcid.org/0000-0002-7465-3616
Mohamed ArafaDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID https://orcid.org/0000-0003-0107-8857
Nicholas TadrosDivision of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA.ORCID https://orcid.org/0000-0002-2272-235X
Ranjith RamasamyDepartment of Urology, University of Miami, Miami, FL, USA.ORCID https://orcid.org/0000-0003-1387-7904
Parviz KavoussiAustin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA.ORCID https://orcid.org/0000-0001-7390-5837
Rafael AmbarUrology Department of Centro Universitario em Saude do ABC, Santo André, Brazil.ORCID https://orcid.org/0000-0002-3496-2895
Manish KuchakullaDepartment of Urology, University of Miami, Miami, FL, USA.ORCID https://orcid.org/0000-0003-2238-6752
Kathy Amy RobertAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.ORCID https://orcid.org/0000-0002-9448-6341
Concetta IovineDepartment of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy.ORCID https://orcid.org/0000-0002-9636-5842
Damayanthi DurairajanayagamDepartment of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Malaysia.ORCID https://orcid.org/0000-0001-9049-0215
Sunil JindalDepartment of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.ORCID https://orcid.org/0000-0002-8088-8710
Rupin ShahDepartment of Urology, Lilavati Hospital and Research Centre, Mumbai, India.ORCID https://orcid.org/0000-0002-7868-5949

Funding

American Center for Reproductive Medicine 500000105879American Center for Reproductive Medicine Andrology Research Fund #500000105879
6 · The paper itself

Abstract

Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations. This article provides an overview of SDF types, origin and comparative analysis of various SDF assays while primarily focusing on the clinical indications of SDF testing. Importantly, we report four clinical cases where SDF testing had played a significant role in improving fertility outcome. In light of these clinical case reports and recent scientific evidence, this review provides expert recommendations on SDF testing and examines the advantages and drawbacks of the clinical utility of SDF testing using Strength-Weaknesses-Opportunities-Threats (SWOT) analysis.

Indexed as

Assisted reproductive techniques outcomeClinical guidelinesInfertility, maleOxidative stressSperm DNA fragmentation

Identifiers

PMID32777871
PMCPMC7502318

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.