TY - JOUR
T1 - Global Andrology Forum Clinical Guidelines on the Relevance of Sperm DNA Fragmentation in Reproductive Medicine
AU - Çayan, Selahittin
AU - Farkouh, Ala'a
AU - Agarwal, Ashok
AU - Atmoko, Widi
AU - Wyns, Christine
AU - Arafa, Mohamed
AU - Zini, Armand
AU - Shah, Rupin
AU - Alipour, Hiva
AU - Chung, Eric
AU - Saleh, Ramadan
AU - Pinggera, Germar Michael
AU - Konstantinidis, Charalampos
AU - Hashimi, Manaf Al
AU - Pescatori, Edoardo
AU - Rambhatla, Amarnath
AU - Toprak, Tuncay
AU - Calogero, Aldo E.
AU - Gül, Murat
AU - Park, Hyun Jun
AU - Altay, Baris
AU - Falcone, Marco
AU - Rashed, Ayman
AU - Le, Tan V.
AU - Bahar, Fahmi
AU - Shatylko, Taras
AU - Görür, Sadık
AU - El-Sakka, Ahmed I.
AU - Saylam, Barış
AU - Sarikaya, Selcuk
AU - Smith, Ryan Patrick
AU - Boeri, Luca
AU - Efesoy, Ozan
AU - Ceyhan, Erman
AU - Russo, Giorgio Ivan
AU - Ozer, Cevahir
AU - Ho, Christopher Chee Kong
AU - Gungor, Nur Dokuzeylul
AU - Özlü, Deniz Noyan
AU - Molina, Juan Manuel Corral
AU - Musa, Muhammad Ujudud
AU - Tsujimura, Akira
AU - Gokalp, Fatih
AU - Mohamed, Mohamed Saeed
AU - Okada, Keisuke
AU - Khalafalla, Kareim
AU - Kuroda, Shinnosuke
AU - Binsaleh, Saleh
AU - Motawi, Ahmad Tarek
AU - Shamohammadi, Iman
AU - Mogharabian, Nasser
AU - Manh, Manh Truong
AU - Taha, Emad Abdelraheem
AU - Makarounis, Konstantinos
AU - Mak, Siu King
AU - Shedeed, Shedeed Ashour
AU - Thomas, Charalampos
AU - Mostafa, Taymour
N1 - Publisher Copyright:
Copyright © 2025 Korean Society for Sexual Medicine and Andrology.
PY - 2026/1
Y1 - 2026/1
N2 - Purpose: To evaluate the evidence on sperm DNA fragmentation (SDF) and its clinical applications in reproductive medicine, highlighting benefits, limitations, and guidelines for its use to assist clinicians in objective decision-making. Materials and Methods: A multidisciplinary team of clinicians and reproductive experts from the Global Andrology Forum (GAF) reviewed the latest evidence on SDF, covering indications, testing methods, recurrent pregnancy loss, varicocele and its repair, assisted reproductive technologies (ART), treatment of associated conditions, antioxidant therapy, and sperm selection for ART. Expert statements and recommendations were developed and graded with the GRADE system using a modified Delphi process. Results: Based on the GAF surveys, systematic reviews, and meta-analyses related to SDF, 52 experts introduced and scored 24 statements and recommendations using the GRADE system. Of these, 87.5% (21/24) achieved strong ratings, reflecting broad consensus, while 12.5% (3/24) were rated weak. The guidelines provide evidence-based recommendations for clinical scenarios, including the role of SDF in infertility, recurrent pregnancy loss, and ART outcomes. Conclusions: While there is growing interest and evidence regarding the clinical benefit of SDF testing and its utility in managing male infertility, significant gaps in the literature limit its routine use in clinical practice. The guidelines offer a structured framework for integrating SDF testing into male infertility management, emphasizing a tailored approach based on individual clinical scenarios. Clinicians must balance the benefits and limitations of SDF testing and antioxidant treatment to optimize care in reproductive medicine. These guidelines are critical for advancing evidence-based practices in male infertility management.
AB - Purpose: To evaluate the evidence on sperm DNA fragmentation (SDF) and its clinical applications in reproductive medicine, highlighting benefits, limitations, and guidelines for its use to assist clinicians in objective decision-making. Materials and Methods: A multidisciplinary team of clinicians and reproductive experts from the Global Andrology Forum (GAF) reviewed the latest evidence on SDF, covering indications, testing methods, recurrent pregnancy loss, varicocele and its repair, assisted reproductive technologies (ART), treatment of associated conditions, antioxidant therapy, and sperm selection for ART. Expert statements and recommendations were developed and graded with the GRADE system using a modified Delphi process. Results: Based on the GAF surveys, systematic reviews, and meta-analyses related to SDF, 52 experts introduced and scored 24 statements and recommendations using the GRADE system. Of these, 87.5% (21/24) achieved strong ratings, reflecting broad consensus, while 12.5% (3/24) were rated weak. The guidelines provide evidence-based recommendations for clinical scenarios, including the role of SDF in infertility, recurrent pregnancy loss, and ART outcomes. Conclusions: While there is growing interest and evidence regarding the clinical benefit of SDF testing and its utility in managing male infertility, significant gaps in the literature limit its routine use in clinical practice. The guidelines offer a structured framework for integrating SDF testing into male infertility management, emphasizing a tailored approach based on individual clinical scenarios. Clinicians must balance the benefits and limitations of SDF testing and antioxidant treatment to optimize care in reproductive medicine. These guidelines are critical for advancing evidence-based practices in male infertility management.
KW - DNA fragmentation
KW - Infertility, male
KW - Practice guideline
KW - Reproductive medicine
KW - Spermatozoa
UR - https://www.scopus.com/pages/publications/105005301907
U2 - 10.5534/wjmh.250005
DO - 10.5534/wjmh.250005
M3 - Article
AN - SCOPUS:105005301907
SN - 2287-4208
VL - 43
JO - World Journal of Men's Health
JF - World Journal of Men's Health
ER -
SDG 3 Good Health and Well-being