Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility A Global Survey, Current Guidelines, and Expert Recommendations

被引：8

作者：

Agarwal, Ashok ^{[1
,2
]}

Farkouh, Ala'a ^{[1
]}

Saleh, Ramadan ^{[1
,3
]}

Hamoda, Taha Abo-Almagd Abdel-Meguid ^{[1
,4
,5
]}

Salvio, Gianmaria ^{[1
,6
]}

Boitrelle, Florence ^{[1
,7
,8
]}

Harraz, Ahmed M. ^{[1
,9
,10
,11
]}

Abou Ghayda, Ramy ^{[1
,10
,12
]}

Kavoussi, Parviz ^{[1
,13
]}

Gul, Murat ^{[1
,14
]}

Toprak, Tuncay ^{[1
,15
]}

Russo, Giorgio Ivan ^{[1
,16
]}

Durairajanayagam, Damayanthi ^{[1
,17
]}

Rambhatla, Amarnath ^{[1
,18
]}

Birowo, Ponco ^{[1
,19
]}

Cannarella, Rossella ^{[1
,20
,21
]}

Nguyen Ho Vinh Phuoc ^{[1
,22
,23
]}

Zini, Armand ^{[1
,24
]}

Arafa, Mohamed ^{[1
,25
,26
,27
]}

Wyns, Christine ^{[1
,28
]}

Tremellen, Kelton ^{[1
,29
]}

Sarikaya, Selcuk ^{[1
,30
]}

Lewis, Sheena ^{[1
,31
]}

Evenson, Donald P. ^{[1
,32
]}

Ko, Edmund ^{[1
,33
]}

Calogero, Aldo E. ^{[1
,10
]}

Bahar, Fahmi ^{[1
,34
]}

Martinez, Marlon ^{[1
,35
]}

Ambar, Rafael F. ^{[1
,36
,37
]}

Colpi, Giovanni M. ^{[1
,38
]}

Bakircioglu, Mustafa Emre ^{[1
,39
]}

Henkel, Ralf ^{[1
,40
,41
]}

Kandil, Hussein ^{[1
,42
]}

Serefoglu, Ege Can ^{[1
,43
]}

Alfakhri, Abdullah ^{[1
,44
]}

Tsujimura, Akira ^{[1
,45
]}

Kheradmand, Alireza ^{[1
,46
]}

Marino, Angelo ^{[1
,47
]}

Adamyan, Aram ^{[1
,48
]}

Zilaitiene, Birute ^{[1
,49
]}

Ozer, Cevahir ^{[1
,50
]}

Pescatori, Edoardo ^{[1
,51
]}

Vogiatzi, Paraskevi ^{[1
,52
]}

Busetto, Gian Maria ^{[1
,53
]}

Balercia, Giancarlo ^{[1
,6
]}

Elbardisi, Haitham ^{[1
,25
,26
,54
]}

Akhavizadegan, Hamed ^{[1
,55
]}

Sajadi, Hesamoddin ^{[1
,56
]}

Taniguchi, Hisanori ^{[1
,57
]}

Park, Hyun Jun ^{[1
,58
,59
]}

机构：

[1] Global Androl Forum, 130 West Juniper Lane, Moreland Hills, OH 44022 USA

[2] Cleveland Clin, Cleveland, OH 44106 USA

[3] Sohag Univ, Dept Dermatol Venereol & Androl, Fac Med, Sohag, Egypt

[4] King Abdulaziz Univ, Dept Urol, Jeddah, Saudi Arabia

[5] Minia Univ, Dept Urol, Fac Med, Al Minya, Egypt

[6] Polytech Univ Marche, Dept Endocrinol, Ancona, Italy

[7] Poissy Hosp, Reprod Biol, Fertil Preservat, Androl,CECOS, Poissy, France

[8] Paris Saclay Univ, Dept Biol Reprod Epigenet Environm & Dev, UVSQ, INRAE,BREED, Jouy En Josas, France

[9] Urol & Nephrol Ctr, Mansoura, Egypt

[10] Farwaniya Hosp, Dept Surg, Urol Unit, Farwaniya, Kuwait

[11] Sabah Al Ahmad Urol Ctr, Dept Urol, Kuwait, Kuwait

[12] Case Western Reserve Univ, Univ Hosp, Inst Urol, Cleveland, OH USA

[13] Austin Fertil & Reprod Med Westlake IVF, Dept Reprod Urol, Austin, TX USA

[14] Selcuk Univ, Dept Urol, Sch Med, Konya, Turkiye

[15] Univ Hlth Sci, Fatih Sultan Mehmet Training & Res Hosp, Dept Urol, Istanbul, Turkiye

[16] Univ Catania, Urol Sect, Catania, Italy

[17] Univ Teknol MARA, Dept Physiol, Fac Med, Sungai Buloh Campus, Shah Alam, Selangor, Malaysia

[18] Henry Ford Hlth Syst, Vattikuti Urol Inst, Dept Urol, Detroit, MI USA

[19] Univ Indonesia, Dr Cipto Mangunkusumo Gen Hosp, Dept Urol, Fac Med, Jakarta, Indonesia

[20] Univ Catania, Dept Clin & Expt Med, Catania, Italy

[21] Cleveland Clin Fdn, Glickman Urol & Kidney Inst, Dept Urol, Cleveland, OH USA

[22] Binh Dan Hosp, Dept Androl, Ho Chi Minh City, Vietnam

[23] Pham Ngoc Thach Univ Med, Dept Urol & Androl, Ho Chi Minh City, Vietnam

[24] McGill Univ, Dept Surg, Montreal, PQ, Canada

[25] Hamad Med Corp, Dept Urol, Doha, Qatar

[26] Weill Cornell Med Qatar, Dept Urol, Doha, Qatar

[27] Cairo Univ, Dept Androl & STDs, Cairo, Egypt

[28] Catholic Univ Louvain, Clin Univ St Luc, Dept Gynaecol Androl, Brussels, Belgium

[29] Flinders Univ S Australia, Dept Obstet Gynaecol & Reprod Med, Bedford Pk, SA, Australia

[30] Univ Hlth Sci, Galhane Res & Training Hosp, Dept Urol, Ankara, Turkiye

[31] Examen Lab Ltd, Belfast, Antrim, North Ireland

[32] SCSA Diagnost, Brookings, SD USA

[33] Loma Linda Univ Hlth, Dept Urol, Loma Linda, CA USA

[34] Siloam Sriwijaya Hosp, Androl Sect, Palembang, Indonesia

[35] Univ Santo Tomas Hosp, Urol Sect, Dept Surg, Manila, Philippines

[36] Ctr Univ Saude ABC, Dept Urol, Santo Andre, SP, Brazil

[37] Ideia Fertil Inst Human Reprod, Androl Grp, Santo Andre, SP, Brazil

[38] Next Fertil Procrea, Androl & IVF Ctr, Lugano, Switzerland

[39] SENSART Clin, Urol, Istanbul, Turkiye

[40] Imperial Coll London, Dept Metab Digest & Reprod, London, England

[41] Univ Western Cape, Dept Med Biosci, Bellville, South Africa

[42] Fakih IVF Fertil Ctr, Abu Dhabi, U Arab Emirates

[43] Biruni Univ, Dept Urol, Sch Med, Istanbul, Turkiye

[44] King Fahad Med City, Dept Urol, Riyadh, Saudi Arabia

[45] Juntendo Univ, Dept Urol, Urayasu Hosp, Chiba, Japan

[46] Ahvaz Jundishapur Univ Med Sci, Golestan Hosp, Dept Urol, Ahvaz, Iran

[47] ANDROS Day Surg Clin, Reprod Med Unit, Palermo, Italy

[48] Astghik Med Ctr, IVF Dept, Yerevan, Armenia

[49] Lithuanian Univ Hlth Sci, Med Acad, Inst Endocrinol, Kaunas, Lithuania

[50] Baskent Univ, Dept Urol, Fac Med, Ankara, Turkiye

来源：

WORLD JOURNAL OF MENS HEALTH | 2024年 / 42卷 / 01期

关键词：

Delphi method; Diagnostic test; DNA fragmentation; Infertility; male; Survey; DIAGNOSIS; MEN; MANAGEMENT; ANDROLOGY; DAMAGE;

D O I：

10.5534/wjmh.230076

中图分类号：

R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

摘要：

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.

引用

页码：202 / 215

页数：14

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