Sperm DNA Fragmentation

Sperm DNA fragmentation (SDF) has been associated with male infertility, recurrent pregnancy loss, and failure of assisted reproductive technologies. Pathogenesis of SDF involves both intrinsic and extrinsic factors, causing protamine deficiency, abortive apoptosis, and oxidative stress. In the latest edition of the WHO laboratory manual for the examination and processing of human semen, four assays for measuring SDF as an advanced sperm function test are described. Many different risk factors and etiologies have been associated with SDF, including advanced paternal age, clinical varicocele, obesity, male genital tract infections, smoking, alcohol, and noxious exposures. Subsequently, the management of underlying associated etiologies and the use of empiric antioxidants have been shown to reduce SDF levels and improve reproductive outcomes. Other techniques that can be applied to reduce and/or overcome SDF include shorter ejaculatory abstinence, use of advanced sperm selection techniques, and use of testicular sperm.