Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility a global survey, current guidelines, and expert recommendations
Yükleniyor...
Tarih
2024
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Korean Soc Sexual Medicine & Andrology
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the exami-nation and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current profes-sional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuri-dine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely in-fluenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respon-dents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers en-countered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory inter-pretation of SDF testing are crucial.
Açıklama
6. Indonesian Society of Andrological Urology (Gede Wirya Kusuma Duarsa, PhD, Indonesia) . 7. Indonesian Urological Association (Ponco Birowo, MD, PhD Indonesia; Gede Wirya Kusuma Duarsa, PhD, Indonesia; Fahmi Bahar, MD, Indonesia) . 8. Italian Society of Andrology and Sexual Medicine (Aldo E. Calogero, MD, Italy) . 9. Italian Society of Human Reproduction (Carlo Trotta, MD, Italy; Giovanni M. Colpi, MD, Italy; Lucia Rocco, PhD, Italy) . 10. Italian Society of Urology (Gian Maria Busetto, MD, PhD, Italy) . 11. Lebanese Society of Urology (Mohamad Moussa, MD, Lebanon) . 12. Malaysian Society of Andrology and the Study of the Aging Male (Christopher Ho, MD, Malaysia; Kay Seong, NGOO, MD, Malaysia) . 13. Malaysian Urological Association (Teng Aik Ong, MD, Malaysia) . 14. Mediterranean Society for Reproductive Medicine (Hassan Sallam, MD, PhD, Egypt) . 15. Middle East Society for Sexual Medicine (Amr El Meliegy, MD, Egypt) . 16. Romanian Association for Sexual Medicine (Catalina Zenoaga-Barbarosie, MSc, Romania) . 17. Saudi Andrology Group (Naif Alhathal, MD, Saudi Ara-bia) . 18. Society for Men's Health Singapore (King Chien; Joe Lee, MD, Singapore) . 19. Society of Egyptian Fellows and Members of the Royal College of Obstetricians and Gynecologists (Hassan Sallam MD, PhD, Egypt) . 20. Turkish Association of Urology (Arif Kalkanli, MD, Tur-key; Ates Kadioglu, MD, Turkey) . 21. Vietnam Society of Sexual Medicine (Ho Vinh Phuoc Nguyen, MD; Quang Nguyen, MD, PhD; Quang Tien Long Tran, MD; Tan V. Le, MD) .
Anahtar Kelimeler
Delphi Method, Diagnostic Test, DNA Fragmentation, Infertility, Male, Survey
Kaynak
World Journal Of Mens Health
WoS Q Değeri
Q1
Scopus Q Değeri
Q1
Cilt
42
Sayı
1
Künye
Agarwal, A., Farkouh, A. A., Saleh, R., Hamoda, T. A. A. A. M., Salvio, G., Boitrelle, F., ... & Shah, R. (2024). Technical aspects and clinical limitations of sperm DNA fragmentation testing in male infertility: a global survey, current guidelines, and expert recommendations. The world journal of men's health, 42(1), 202.
