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Sperm DNA Fragmentation Testing; a SWOT Analysis

Sperm DNA influences embryo development and, in turn, the likelihood of establishing a healthy pregnancy and delivery in both natural and assisted cases. Roughly 15% of couples are affected by infertility worldwide. Directly or indirectly, male infertility is accountable for 60% of those instances. Still, half of those male infertility cases conclude to be unexplained or idiopathic due to limitations in diagnostic modalities.

SDF or sperm DNA fragmentation is considered a leading cause of male infertility. Evidence supports SDF as a significant factor in several conditions’ pathophysiology, although the mechanisms involved have not been fully described. Measurement of DNA fragmentation levels in sperm provides crucial information and may guide therapeutic strategies. A recent clinical practice guideline (CPG) spotlighted how to use the information provided by SDF testing. This publication sparked a flurry of commentaries, including an abundance of information and conflicting views by leading fertility experts, further exposing SDF’s complex nature.

A search of papers published in response to the CPG entitled “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” was performed within the Translational Andrology and Urology (TAU) website ( They extracted the finer points from each commentary and used the Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis to grasp the drawbacks and advantages of SDF as a clinical practice method.

Fertility experts from six continents contributed commentaries. The SWOT analysis showed that the clinical practice guideline supplies an evidence-based proposition for integrating SDF testing in routine practice. It also revealed information gaps, limiting the widespread application, allowing further opportunity to refine SDF testing.

In conclusion, SDF’s role in male fertility requires an in-depth analysis of the processes and theories involved. This SWOT analysis granted an objective evaluation of CPG on the clinical utility of SDF testing by global experts from all possible angles. The implementation of SDF testing may increase the outcome of ART and improve the health of prospective fathers and their offspring.

As always, MCRM Fertility strives to keep you at the forefront of new information as it becomes available. Our team is here to support you and answer any questions or concerns you may have. 

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