Sperm DNA fragmentation

Numerous studies have demonstrated the detrimental effects of sperm DNA fragmentation (SDF) on reproductive outcomes, whether under natural or assisted conditions. The sperm DNA fragmentation (SDF) test has emerged as a valuable supplement in the evaluation of infertile men, and the rapid development of various SDF tests has enhanced perceptions of their clinical utility. Consequently, the latest manual from the World Health Organization has determined that SDF should be described as a specialized test (and thus applied in many laboratories worldwide) rather than as a tool for research analysis. However, the normal reference ranges for these tests, used to evaluate male fertility potential, remain the topic of debate. This article addresses the pathophysiological aspects of sperm chromatin and the mechanisms underlying sperm DNA fragmentation. The effects of this fragmentation on various reproductive outcomes are also reviewed. In addition, an analysis of the different available fragmentation tests is provided. Finally, we discuss preventive and therapeutic measures to reduce sperm DNA fragmentation, as well as potential future research opportunities.