Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines
Ashok Agarwal, Ala’a Farkouh, Neel Parekh, Armand Zini, Mohamed Arafa, Hussein Kandil, Nicholas N. Tadros, Gian Maria Busetto, Rafael F. Ambar, Sıjo J. Parekattıl, Florence Boitrelle, Hassan Sallam, Sunil Jindal, Edmund Ko, Mara Simopoulou, Hyun Jun Park, Mohammad Ali Sadighi, Ramadan Saleh, Jonathan Ramsay, Marlon Martínez, Haitham Elbardisi, Juan G. Álvarez, Giovanni M. Colpi, Jaime Gosálvez, Donald P. Evenson, Rupin Shah
Abstract
Sperm DNA fragmentation (SDF) is implicated in male infertility and adverse reproductive outcomes. With the publication of many studies regarding the etiologies and contributors to SDF, as well as the effects of SDF, guidelines are necessary to aid clinicians in the application of SDF for male fertility evaluation. Two recent clinical practice guidelines were published by Agarwal et al and Esteves et al. In this article, we have evaluated and compared both guidelines. We have found fairly similar recommendations between the two guidelines and have also highlighted the differences between them. Finally, we have summarized and combined the best practice recommendations from both guidelines.