Should Sperm DNA Fragmentation Testing Be Used in Men with Varicocele?
Current practice in selection of surgical candidates for varicocelectomy based on clinical assessment and semen analysis has its pitfall and drawbacks. The advent of sperm DNA fragmentation (SDF) testing allows the evaluation of sperm quality which is not assessed by conventional semen parameters. The value of SDF testing was supported by the implication of sperm chromatin integrity on both natural and assisted reproductive outcomes. Higher SDF despite fertility status and the reduction of SDF after varicocelectomy in men also offers evidence in support of the use of SDF assays in this patient group. Clinical utilization of SDF testing in selection of surgical candidates has been proposed and recently included in clinical practice guidelines. Although SDF alone is insufficient to predict fertility status, its complementary role in the current practice should be recognized.
KeywordsMale infertility Sperm DNA damage Sperm DNA fragmentation Varicocele Varicocelectomy
- 5.Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2015;103:e18–25.Google Scholar
- 6.Jarow J, Sigman M, Kolettis PN, et al. The optimal evaluation of the infertile male: best practice statement reviewed and validated confirmed 2011. Available online: https://www.auanet.org/education/guidelines/male-infertility-d.cfm.
- 7.Jungwirth A, Diemer T, Dohle GR, et al. Guidelines on male infertility. Available online: https://uroweb.org/guideline/male-infertility/.
- 31.Mohammad EE, Mosad E, Zahran AM, et al. Acridine orange and flow cytometry: which is better to measure the effect of varicocele on sperm DNA integrity? Adv Urol. 2015;2015:814150.Google Scholar