Tharu Tharakan1, Carlo Bettocchi2, Joana Carvalho3, Giovanni Corona4, Thomas Hugh Jones5, Ates Kadioglu6, Juan I Martínez Salamanca7, Ege Can Serefoglu8, Paolo Verze9, Andrea Salonia10, Suks Minhas11. 1. Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, UK; Section of Investigative Medicine, Department of Medicine, Imperial College London, London, UK. 2. Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy. 3. Centre for Psychology, Faculty of Psychology and Educational Sciences, Porto University, Porto, Portugal. 4. Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy. 5. Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Trust, Barnsley, UK. 6. Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey. 7. Department of Urology, Hospital Universitario Puerta del Hierro Majadahonda, Madrid, Spain. 8. Department of Urology, Biruni University School of Medicine, Istanbul, Turkey; Department of Histology & Embryology, Medipol University School of Medicine, Istanbul, Turkey. 9. Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy. 10. Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy. 11. Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London, UK. Electronic address: suks.minhas@nhs.net.
Abstract
Accumulating evidence has highlighted the contribution of oxidative stress and sperm DNA fragmentation (SDF) in the pathophysiology of male infertility. SDF has emerged as a novel biomarker of risk stratification for patients undergoing assisted reproductive technologies. Studies have also supported the use of testicular over ejaculated sperm at the time of intracytoplasmic sperm injection, as testicular sperm may have lower SDF than ejaculated samples. The European Association of Urology Working Panel on Male Sexual and Reproductive Health provides an evidence-based consultation guide on the indications for SDF testing in male infertility and also for testicular sperm extraction (TESE) in nonazoospermic men. We present the limitations and advantages of SDF testing and a framework to ensure that it is appropriately utilised in clinical practice. Furthermore, we critically appraise the current literature advocating the use of TESE in nonazoospermic men. PATIENT SUMMARY: This article reviews the evidence supporting the use of sperm DNA fragmentation testing in the assessment of male infertility and testicular sperm extraction in nonazoospermic men.
Accumulating evidence has highlighted the contribution of oxidative stress and sperm DNA fragmentation (SDF) in the pathophysiology of male infertility. SDF has emerged as a novel biomarker of risk stratification for patients undergoing assisted reproductive technologies. Studies have also supported the use of testicular over ejaculated sperm at the time of intracytoplasmic sperm injection, as testicular sperm may have lower SDF than ejaculated samples. The European Association of Urology Working Panel on Male Sexual and Reproductive Health provides an evidence-based consultation guide on the indications for SDF testing in male infertility and also for testicular sperm extraction (TESE) in nonazoospermic men. We present the limitations and advantages of SDF testing and a framework to ensure that it is appropriately utilised in clinical practice. Furthermore, we critically appraise the current literature advocating the use of TESE in nonazoospermic men. PATIENT SUMMARY: This article reviews the evidence supporting the use of sperm DNA fragmentation testing in the assessment of male infertility and testicular sperm extraction in nonazoospermic men.
Authors: Patrícia de Moraes De Zorzi; Ana Paula de Souza Kussler; Anita Mylius Pimentel; Edison Capp; Helena von Eye Corleta Journal: JBRA Assist Reprod Date: 2022-04-17
Authors: Ashok Agarwal; Ala'a Farkouh; Neel Parekh; Armand Zini; Mohamed Arafa; Hussein Kandil; Nick Tadros; Gian Maria Busetto; Rafael Ambar; Sijo Parekattil; Florence Boitrelle; Hassan Sallam; Sunil Jindal; Edmund Ko; Mara Simopoulou; Hyun Jun Park; Mohammad Ali Sadighi; Ramadan Saleh; Jonathan Ramsay; Marlon Martinez; Haitham Elbardisi; Juan Alvarez; Giovanni Colpi; Jaime Gosalvez; Donald Evenson; Rupin Shah Journal: World J Mens Health Date: 2021-04-21 Impact factor: 5.400