Impact of Sperm DNA Fragmentation on Natural and Assisted Conception

Current evidence suggests significant negative correlation of sperm DNA fragmentation (SDF) with basic sperm parameters and chances of spontaneous pregnancy. Additionally, SDF has been correlated negatively with assisted reproduction technique outcomes such as fertilization rate, pregnancy rate, and live birth rate. Several etiologies and risk factors have been suggested for the pathogenesis of SDF including varicocele, environmental exposures, and lifestyle factors among others. This chapter aims to discuss the mechanisms of pathogenesis of SDF, impact of SDF on fertility outcomes under natural and assisted conception conditions, indications and techniques of SDF testing, and management strategies that help reduce elevated SDF and enhance reproductive outcomes.