Consequences of sperm DNA fragmentation for assisted reproductive technology

The possession of offspring is the most important human biological goal, which conditions the survival of the human species. The problem of the lack of offspring is a phenomenon concerning approximately 15% of married couples in Poland. In a half of the cases, the causative agent is the male factor infertility problem. It is considered that in approximately 20% of patients with idiopathic infertility, and elevated level of sperm DNA fragmentation may be the cause of failure in reproduction. High levels of sperm DNA fragmentation have also been associated with decreased oocyte fecundation, embryo quality and pregnancy rate. The quality of the genetic material carried in male sperm becomes a prognostic factor in the area of the effectiveness of treatment of an infertile couple, bearing a healthy child, as well as the risk of contracting cancer in the future generations. Present data on the consequences of sperm DNA fragmentation (SDF) for reproduction are scarce and, in many ways, inconsistent. The differences in the study conclusions might result from the different methods used to detect SDF, the study design and the inclusion criteria. Consequently, it is difficult to decide whether SDF testing should be carried out in fertility assessment and assisted reproductive technology (ART). It is clear that there is an urgent need for the standardization of the methods and the need for additional clinical studies on the impact of SDF on ART outcomes.