Sperm DNA fragmentation testing: ready for prime time?

tau.amegroups.com © Translational Andrology and Urology. All rights reserved. The authors present fair evidence indicating that sperm DNA fragmentation (SDF) testing is a useful diagnostic tool in male fertility evaluation. As such, they propose that SDF should be included in the evaluation of male factor fertility along with the semen analysis, and provide data for recommendation for testing under specific clinical scenarios (1). Among various available tests, the authors highlight two assays for SDF testing, the TUNEL technique (sensitive, reliable with minimal inter-observer variability, but requiring standardization between laboratories) and the SCSA (reliable but requiring more expensive instrumentation and skilled technicians). The authors quote a limited number of studies that show that SDF levels can predict the likelihood of natural pregnancy, and that higher SDF is associated with lower IUI pregnancy rates, and with lower embryo quality and pregnancy rates in the IVF/ICSI scenario. Within this context some other points warrant discussion, as elaborated in earlier publications (2-4).