Evidence map›Paper›PMID 37118960›Full record

ArticleThe world journal of men's health2023

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations.

Ashok Agarwal, Ala'a Farkouh, Ramadan Saleh, Taha Abo-Almagd Abdel-Meguid Hamoda, Ahmed M Harraz, Parviz Kavoussi, Mohamed Arafa, Gianmaria Salvio, Amarnath Rambhatla, Tuncay Toprak and 133 more

Open access · diamondAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The world journal of men's health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed
7.4field-weighted citation impact, top 2% of its field
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

27 citing papers in PubMed, 27 citations in OpenAlex.

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  6. Review
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  9. Review
  10. The role of sperm DNA fragmentation in reproduction: a SWOT analysis.Journal of assisted reproduction and genetics · 2025
    Review
  11. Article
  12. Article
  13. Article
  14. Sperm DNA Fragmentation and Fertility.Advances in experimental medicine and biology · 2025
    Review
  15. Article
  16. Article
  17. Review
  18. Article
  19. Article
  20. Article
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

143 authors at 20 institutions in 42 countries.

Ashok AgarwalGlobal Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USA.ORCID 0000-0003-0585-1026
Ala'a FarkouhGlobal Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USA.ORCID 0000-0002-0362-9109
Ramadan SalehDepartment of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.ORCID 0000-0003-0503-3533
Taha Abo-Almagd Abdel-Meguid HamodaDepartment of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.ORCID 0000-0002-8070-4088
Ahmed M HarrazUrology and Nephrology Center, Mansoura University, Mansoura, Egypt.ORCID 0000-0002-8902-517X
Parviz KavoussiDepartment of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA.ORCID 0000-0001-7390-5837
Mohamed ArafaDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0003-0107-8857
Gianmaria SalvioDepartment of Endocrinology, Polytechnic University of Marche, Ancona, Italy.ORCID 0000-0001-9290-5699
Amarnath RambhatlaDepartment of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA.ORCID 0000-0002-1383-6670
Tuncay ToprakDepartment of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.ORCID 0000-0003-1348-5273
Murat GülDepartment of Urology, Selçuk University School of Medicine, Konya, Turkey.ORCID 0000-0002-6657-6227
Nguyen Ho Vinh PhuocDepartment of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam.ORCID 0000-0002-4348-6034
Florence BoitrelleReproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.ORCID 0000-0002-5322-0141
Ponco BirowoDepartment of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.ORCID 0000-0003-2934-6753
Ramy Abou GhaydaUrology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA.ORCID 0000-0002-5170-3983
Rossella CannarellaDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.ORCID 0000-0003-4599-8487
Shinnosuke KurodaDepartment of Urology, Cleveland Clinic, Cleveland, OH, USA.ORCID 0000-0001-8890-0297
Damayanthi DurairajanayagamDepartment of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.ORCID 0000-0001-9049-0215
Armand ZiniDepartment of Surgery, McGill University, Montreal, QC, Canada.ORCID 0000-0002-2194-5578
Christine WynsDepartment of Gynaecology-Andrology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.ORCID 0000-0002-6581-5003
Selcuk SarikayaDepartment of Urology, Gülhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey.ORCID 0000-0001-6426-1398
Kelton TremellenDepartment of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia.ORCID 0000-0001-5575-6049
Taymour MostafaDepartment of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.ORCID 0000-0003-3627-0662
Ioannis SokolakisDepartment of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany.ORCID 0000-0002-1938-8004
Donald P EvensonSCSA Diagnostics, Brookings, SD, USA.ORCID 0000-0002-9085-0097
Ralf HenkelDepartment of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.ORCID 0000-0003-1128-2982
Wael ZohdyDepartment of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.ORCID 0000-0001-9148-1425
Eric ChungDepartment of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia.ORCID 0000-0003-3373-3668
Imad ZiouziouDepartment of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco.ORCID 0000-0002-9844-6080
Marco FalconeDepartment of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy.ORCID 0000-0003-1101-892X
Giorgio I RussoUrology Section, University of Catania, Catania, Italy.ORCID 0000-0003-4687-7353
Manaf Al-HashimiDepartment of Urology, Burjeel Hospital, Abu Dhabi, UAE.ORCID 0000-0002-2458-179X
Aldo E CalogeroDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.ORCID 0000-0001-6950-335X
Edmund KoDepartment of Urology, Loma Linda University Health, Loma Linda, CA, USA.ORCID 0000-0002-7465-3616
Giovanni ColpiAndrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland.ORCID 0000-0003-1431-1777
Sheena LewisExamen Lab Ltd., Northern Ireland, UK.ORCID 0000-0001-5665-1572
Ege Can SerefogluDepartment of Urology, Biruni University School of Medicine, Istanbul, Turkey.ORCID 0000-0002-2530-7012
Fahmi BaharAndrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia.ORCID 0000-0002-7027-9436
Marlon MartinezSection of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines.ORCID 0000-0002-1191-8154
Quang NguyenCenter for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam.ORCID 0000-0002-1670-8885
Rafael F AmbarDepartment of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil.ORCID 0000-0002-3496-2895
Mustafa Emre BakirciogluSENSART Clinic, Urology, Fulya, Istanbul, Turkiye.ORCID 0000-0003-2411-9703
Hussein KandilFakih IVF Fertility Center, Abu Dhabi, UAE.ORCID 0000-0002-5549-3274
Nasser MogharabianSexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran.ORCID 0000-0001-8795-973X
Marjan SabbaghianDepartment of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.ORCID 0000-0001-9439-268X
Hisanori TaniguchiDepartment of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan.ORCID 0000-0002-7404-0369
Akira TsujimuraDepartment of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.ORCID 0000-0002-3821-5184
Hesamoddin SajadiDepartment of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.ORCID 0000-0002-7198-0312
Wael IbrahimDepartment of Obstetrics Gynaecology and Reproductive Medicine, Fertility Care Center in Cairo, Cairo, Egypt.ORCID 0000-0002-1651-8598
Widi AtmokoDepartment of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.ORCID 0000-0002-7793-7083
Paraskevi VogiatziAndromed Health & Reproduction, Fertility & Reproductive Health Diagnostic Center, Athens, Greece.ORCID 0000-0001-9971-1619
Sezgin GunesDepartment of Medical Biology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey.ORCID 0000-0002-3103-6482
Mohammad Ali Sadighi GilaniDepartment of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.ORCID 0000-0001-6168-8599
Shubhadeep RoychoudhuryDepartment of Life Science and Bioinformatics, Assam University, Silchar, India.ORCID 0000-0003-4174-1852
Nur Dokuzeylül GüngörDepartment of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey.ORCID 0000-0002-7234-3876
Lukman HakimDepartment of Urology, Faculty of Medicine Universitas Airlangga, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia.ORCID 0000-0003-1518-8010
Ricky AdriansjahDepartment of Urology, Faculty of Medicine Universitas Padjajaran, Hasan Sadikin General Hospital, Bandung, Indonesia.ORCID 0000-0002-9733-3092
Priyank KothariDepartment of Urology, Topiwala National Medical College, B.Y.L Nair Ch Hospital, Mumbai, India.ORCID 0000-0002-3940-952X
Sunil JindalDepartment of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.ORCID 0000-0002-8088-8710
Edouard AmarDepartment of Urology, American Hospital of Paris, Paris, France.ORCID 0000-0002-0617-8024
Hyun Jun ParkDepartment of Urology, Pusan National University School of Medicine, Busan, Korea.ORCID 0000-0003-0566-9574
Tran Quang Tien LongDepartment of Obstetrics and Gynecology, Hanoi Obstetric and Gynecology Hospital, Hanoi, Vietnam.ORCID 0000-0001-8905-3130
Sheryl HomaDepartment of Biosciences, University of Kent, Canterbury, UK.ORCID 0000-0001-5027-0066
Vilvapathy Senguttuvan KarthikeyanAndrology Unit, Department of Urology, Apollo Hospitals, Greams Road, Chennai, India.ORCID 0000-0002-0244-476X
Birute ZilaitieneInstitute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.ORCID 0000-0002-4082-4843
Israel Maldonado RosasIVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico.ORCID 0000-0003-2765-6176
Angelo MarinoReproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy.ORCID 0000-0002-3558-8153
Edoardo PescatoriAndrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy.ORCID 0000-0002-9326-5598
Cevahir OzerDepartment of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey.ORCID 0000-0002-7850-6912
Hamed AkhavizadeganDepartment of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.ORCID 0000-0002-5432-7311
Nicolas GarridoIVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.ORCID 0000-0001-8271-5218
Gian Maria BusettoDepartment of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy.ORCID 0000-0002-7291-0316
Aram AdamyanIVF Department, Astghik Medical Center, Yerevan, Armenia.ORCID 0000-0002-7213-7212
Mohamed Al-MarhoonDivision of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Sultanate of Oman.ORCID 0000-0002-8397-1560
Haitham ElbardisiDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0003-3902-7924
Parisa DolatiDepartment of Animal Science, Faculty of Agriculture, University of Shiraz, Iran.ORCID 0000-0002-1591-6180
Mahsa DarbandiFetal Health Research Center, Hope Generation Foundation, Tehran, Iran.ORCID 0000-0002-2243-9319
Sara DarbandiFetal Health Research Center, Hope Generation Foundation, Tehran, Iran.ORCID 0000-0002-1868-6712
Giancarlo BalerciaDepartment of Endocrinology, Polytechnic University of Marche, Ancona, Italy.ORCID 0000-0003-1286-1521
Germar-Michael PinggeraDepartment of Urology, Innsbruck Medical University, Innsbruck, Austria.ORCID 0000-0001-6463-2494
Sava MicicDepartment of Andrology, Uromedica Polyclinic, Belgrade, Serbia.ORCID 0000-0001-9037-3318
Christopher Chee Kong HoDepartment of Surgery, School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia.ORCID 0000-0002-8757-6867
Mohamad MoussaDepartment of Urology, Lebanese University, Beirut, Lebanon.ORCID 0000-0001-8571-2768
Mirko PretoDepartment of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy.ORCID 0000-0002-8144-6498
Cătălina Zenoaga-BarbăroșieDepartment of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania.ORCID 0000-0002-2854-9834
Ryan P SmithDepartment of Urology, University of Virginia School of Medicine, Virginia, USA.ORCID 0000-0002-3880-9740
Raghavender KosgiDepartment of Urology, Andrology and Renal Transplant, AIG Hospitals, Hyderabad, India.ORCID 0000-0002-2178-0857
Jean de la RosetteDepartment of Urology, Istanbul Medipol Mega University Hospital, Istanbul, Turkey.ORCID 0000-0002-6308-1763
Ahmed I El-SakkaDepartment of Urology, Suez Canal University, Ismailia, Egypt.ORCID 0000-0001-8671-5952
Saad Mohammed AbumelhaDivision of Urology, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.ORCID 0000-0003-1885-3856
Tiago Cesar MierzwaAndrolab, Fertility Clinic, Curitiba, PR, Brazil.ORCID 0000-0001-7574-9540
Teng Aik OngDepartment of Surgery, University of Malaya, Kuala Lumpur, Malaysia.ORCID 0000-0002-0207-8966
Saleem A BanihaniDepartment of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan.ORCID 0000-0002-6830-6247
Kasonde BowaDepartment of Urology, University of Lusaka, Lusaka, Zambia.ORCID 0000-0001-7032-7998
Shinichiro FukuharaDepartment of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan.ORCID 0000-0003-1336-4316
Luca BoeriDepartment of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.ORCID 0000-0003-0040-784X
Yavuz Onur DanacıoğluDepartment of Urology, University of Health Science Istanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.ORCID 0000-0002-3170-062X
Fatih GokalpDepartment of Urology, Hatay Mustafa Kemal University, Antakya, Turkey.ORCID 0000-0003-3099-3317
Osama Mohamed SelimDepartment of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt.ORCID 0000-0003-1304-1293
Chak-Lam ChoS. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.ORCID 0000-0003-2520-6833
Nicholas N TadrosDivision of Urology, Southern Illinois University, Springfield, IL, USA.ORCID 0000-0002-2272-235X
Muhammet Rasit UgurIVF Michigan, Bloomfield Hills, MI, USA.ORCID 0000-0003-1234-6693
Mehmet Serkan OzkentDepartment of Urology, Konya City Hospital, Konya, Turkey.ORCID 0000-0002-6613-0671
Peter ChiuS. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.ORCID 0000-0002-1499-8372
Arif KalkanliDepartment of Urology, Taksim Education and Research Hospital, Istanbul, Turkey.ORCID 0000-0001-6509-4720
Kareim KhalafallaDepartment of Urology, Hamad Medical Corporation, Doha, Qatar.ORCID 0000-0001-9476-4869
Ranjit B VishwakarmaDepartment of Urology, Lilavati Hospital and Research Centre, Mumbai, India.ORCID 0000-0002-6784-2830
Federica FinocchiDepartment of Endocrinology, Polytechnic University of Marche, Ancona, Italy.ORCID 0000-0003-1551-5990
Sotiris AndreadakisPrivate Practice, Thessaloniki, Greece.ORCID 0000-0003-0367-6105
Carlo GiulioniDepartment of Urology, Polytechnic University of Marche Region, Ancona, Italy.ORCID 0000-0001-9934-4011
Gökhan ÇekerDepartment of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.ORCID 0000-0002-7891-9450
Erman CeyhanDepartment of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey.ORCID 0000-0001-8223-6399
Vineet MalhotraDepartment of Urology, SCM Clinic and Hospital, New Delhi, India.ORCID 0000-0001-6760-0885
Mehmet YilmazDepartment of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Freiburg, Germany.ORCID 0000-0003-3774-9982
Massimiliano TimpanoDepartment of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy.ORCID 0000-0002-2507-6728
Trenton L BarrettPerth Urology Clinic, Perth, WA, Australia.ORCID 0000-0001-5838-8309
Shannon Hee Kyung KimIVF Australia, Sydney, Australia.ORCID 0000-0003-3203-5120
Sun-Tae AhnDepartment of Urology, Korea University College of Medicine, Seoul, Korea.ORCID 0000-0003-1233-5951
Filippo GiaconeCentro HERA, Unità di Medicina della Riproduzione, Sant'Agata Li Battiati, Catania, Italy.ORCID 0000-0003-0510-4039
Ayad PalaniResearch Centre, University of Garmian, Kalar, Iraq.ORCID 0000-0001-7806-9903
Gede Wirya Kusuma DuarsaDepartment of Urology, Udayana University, Denpasar, Indonesia.ORCID 0000-0002-0642-159X
Ates KadiogluSection of Andrology, Department of Urology, Istanbul University, Istanbul, Turkey.ORCID 0000-0002-4239-7638
Franco GaddaDepartment of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.ORCID 0000-0001-6001-1252
Daniel Suslik ZylbersztejnFleury Group and Hospital Israelita Albert Einstein, São Paulo, Brazil.ORCID 0000-0002-1481-0296
Kaan AydosDepartment of Urology, Ankara University, Ankara, Turkey.ORCID 0000-0001-7691-5459
Deniz KulaksızDepartment of Obstetrics and Gynecology, University of Health Sciences Kanuni Training and Research Hospital, Trabzon, Turkey.ORCID 0000-0003-2351-1367
Deepak GupteDepartment of Urology, Bombay Hospital and Medical Research Center, Mumbai, India.ORCID 0000-0002-8522-2299
Gokhan CalikDepartment of Urology, Istanbul Medipol University, Istanbul, Turkey.ORCID 0000-0002-9976-9666
Keshab Kumar KarnaDepartment of Molecular Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA, USA.ORCID 0000-0003-1389-8975
Panagiotis DrakopoulosCentre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.ORCID 0000-0002-9262-785X
Aykut BaserDepartment of Urology, Bandirma Onyedi Eylül University, Balikesir, Turkey.ORCID 0000-0003-0457-512X
Vijay KumarDepartment of Microbiology, Kurukshetra University, Kurukshetra, India.ORCID 0000-0003-3768-8104
Juan Manuel Corral MolinaUrology Department, Hospital Clinic of Barcelona, Barcelona, Spain.ORCID 0000-0003-1423-0256
Osvaldo RajmilDepartment of Andrology, Fundacio Puigvert, Barcelona, Spain.ORCID 0000-0003-1987-9206
Raphael H FerreiraDepartment of Urology, Santa Casa de Ribeirão Preto, São Paulo, Brazil.ORCID 0000-0002-5160-4846
Sofia LeonardiCentral Laboratory, Hospital Publico Materno Infantil de Salta, Salta, Argentina.ORCID 0000-0003-4334-2556
Armen AvoyanUrology Department, Astghik Medical Center, Yerevan, Armenia.ORCID 0000-0002-0495-6582
Emrullah SogutdelenDepartment of Urology, Bolu Abant Izzet Baysal University, Bolu, Turkey.ORCID 0000-0002-1454-5672
Giorgio FrancoDepartment of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.ORCID 0000-0003-3653-3389
Jonathan RamsayDepartment of Andrology, Hammersmith Hospital, London, UK.ORCID 0000-0002-2403-7698
Liliana RamirezIVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico.ORCID 0000-0002-8596-0654
Rupin ShahDepartment of Urology, Lilavati Hospital and Research Centre, Mumbai, India.ORCID 0000-0002-7868-5949
Global Andrology Forum
Cairo University · EGMarche Polytechnic University · ITFondazione Ricerca Molinette · ITRoyan Institute · IRUniversity of Catania · ITBaşkent University · TRChinese University of Hong Kong · HKCleveland Clinic · USFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico · ITGeneration Foundation · USInformation Group on Reproductive Choice · MXIstanbul Medipol University · TRLilavati Hospital & Research Centre · INSağlık Bilimleri Üniversitesi · TRUniversity of Health Science · KHUniversity of Indonesia · IDAirlangga University · IDAmerican Society for Reproductive Medicine · USAndros Clinica Day Surgery · ITAnkara University · TR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. MATERIALS AND

methodsClinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus.

resultsThe survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing.

conclusionsThis article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.

Indexed as

Delphi methodDNA fragmentationMale infertilityPractice guidelinesSpermSurvey

Identifiers

PMID37118960
PMCPMC10307662
OpenAlexW4364856413

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