Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations - INRAE - Institut national de recherche pour l’agriculture, l’alimentation et l’environnement Access content directly
Journal Articles The World Journal of Men's Health Year : 2023

Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Ashok Agarwal (1) , Ala’a Farkouh (1) , Ramadan Saleh (2) , Taha Abo-Almagd Abdel-Meguid Hamoda (3, 4) , Ahmed M Harraz (5) , Parviz Kavoussi , Mohamed Arafa (6, 7) , Gianmaria Salvio (8) , Amarnath Rambhatla (9) , Tuncay Toprak , Murat Gül (10) , Nguyen Ho Vinh Phuoc , Florence Boitrelle (11, 12) , Ponco Birowo (13) , Ramy Abou Ghayda (14) , Rossella Cannarella (15) , Shinnosuke Kuroda (1) , Damayanthi Durairajanayagam (16) , Armand Zini (17) , Christine Wyns (18) , Selcuk Sarikaya (19) , Kelton Tremellen (20) , Taymour Mostafa (7) , Ioannis Sokolakis (21) , Donald P Evenson , Ralf Henkel (22, 23) , Wael Zohdy (7) , Eric Chung (24) , Imad Ziouziou , Marco Falcone (25) , Giorgio I Russo (26) , Manaf Al-Hashimi (27, 28) , Aldo E Calogero (15) , Edmund Ko (29) , Giovanni Colpi , Sheena Lewis , Ege Can Serefoglu , Fahmi Bahar (30) , Marlon Martinez (31) , Quang Nguyen (32) , Rafael F Ambar , Mustafa Emre Bakircioglu , Hussein Kandil , Nasser Mogharabian (33) , Marjan Sabbaghian (34) , Hisanori Taniguchi (35) , Akira Tsujimura , Hesamoddin Sajadi (34) , Wael Ibrahim , Widi Atmoko (13) , Paraskevi Vogiatzi , Sezgin Gunes (36) , Mohammad Ali Sadighi Gilani (34) , Shubhadeep Roychoudhury (37) , Nur Dokuzeylül Güngör (38) , Lukman Hakim (39) , Ricky Adriansjah (40) , Priyank Kothari , Sunil Jindal , Edouard Amar (41) , Hyun Jun Park (42) , Tran Quang Tien Long , Sheryl Homa (43) , Birute Zilaitiene (44) , Israel Maldonado Rosas , Angelo Marino , Edoardo Pescatori , Cevahir Ozer (45) , Hamed Akhavizadegan (46) , Nicolas Garrido , Gian Maria Busetto (47) , Aram Adamyan , Mohamed Al-Marhoon (48) , Haitham Elbardisi (49, 50) , Parisa Dolati (51) , Mahsa Darbandi , Sara Darbandi , Giancarlo Balercia (8) , Germar-Michael Pinggera (52) , Sava Micic , Christopher Chee Kong Ho (53) , Mohamad Moussa (54) , Mirko Preto (55) , Cătălina Zenoaga-Barbăroşie (56) , Ryan P Smith (57) , Raghavender Kosgi , Jean de La Rosette (58) , Ahmed I El-Sakka , Saad Mohammed Abumelha (3) , Tiago Cesar Mierzwa , Teng Aik Ong (59) , Saleem A Banihani (60) , Kasonde Bowa (61) , Shinichiro Fukuhara (62) , Luca Boeri , Yavuz Onur Danacıoğlu , Fatih Gokalp (63) , Osama Mohamed Selim (64) , Chak-Lam Cho (65) , Nicholas N Tadros , Muhammet Rasit Ugur , Mehmet Serkan Ozkent , Peter Chiu (65) , Arif Kalkanli , Kareim Khalafalla (49, 66) , Ranjit B Vishwakarma (67) , Federica Finocchi (68) , Sotiris Andreadakis , Carlo Giulioni (68) , Gökhan Çeker , Erman Ceyhan (45) , Vineet Malhotra , Mehmet Yilmaz (69) , Massimiliano Timpano (55) , Trenton L Barrett , Shannon Hee Kyung Kim (70) , Sun-Tae Ahn , Filippo Giacone , Ayad Palani (71) , Gede Wirya Kusuma Duarsa (72) , Ates Kadioglu (73) , Franco Gadda , Daniel Suslik Zylbersztejn , Kaan Aydos (74) , Deniz Kulaksız , Deepak Gupte , Gokhan Calik (58) , Keshab Kumar Karna , Panagiotis Drakopoulos (75) , Aykut Baser , Vijay Kumar (76) , Juan Manuel Corral Molina (77) , Osvaldo Rajmil (78) , Raphael H Ferreira , Sofia Leonardi , Armen Avoyan , Emrullah Sogutdelen (79) , Giorgio Franco (80) , Jonathan Ramsay (81) , Liliana Ramirez , Rupin Shah , Vilvapathy Senguttuvan Karthikeyan (67)
1 Cleveland Clinic
2 Sohag University
3 King Abdulaziz University
4 Minia University
5 Mansoura University [Egypt]
6 Weill Cornell Medical College-Qatar, Qatar
7 Cairo University
8 Polytechnic University of Marche [Ancona, Italy] / Università Politecnica delle Marche [Ancona, Italia]
9 Vattikuti Urology Institute
10 Faculty of Medicine - Selcuk University [Konya, Turkey]
11 CHI Poissy-Saint-Germain
12 BREED - Biologie de la Reproduction, Environnement, Epigénétique & Développement
13 Cipto Mangunkusumo Hospital [Jakarta]
14 Case Western Reserve University, Cleveland
15 University of Catania [Italy]
16 UiTM - Universiti Teknologi MARA [Shah Alam]
17 McGill University = Université McGill [Montréal, Canada]
18 Cliniques Universitaires Saint-Luc [Bruxelles]
19 Gulhane Training and Research Hospital
20 Flinders University of South Australia
21 Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany.
22 Imperial College London
23 UWC - University of the Western Cape
24 Princess Alexandra Hospital, Brisbane
25 Molinette Hospital
26 Unict - Università degli studi di Catania = University of Catania
27 Burjeel Hospital
28 Khalifa University
29 Loma Linda University
30 Biruni University
31 University of Santo Tomas [Manila, Philippines]
32 VNU - Vietnam National University [Hanoï]
33 Shahroud University of Medical Sciences
34 Royan Institute for Reproductive Biomedicine [Tehran, Iran]
35 Kansai University
36 OMU - Ondokuz Mayis University
37 Assam University
38 Bahcesehir University [Istanbul]
39 UNAIR - Universitas Airlangga
40 UnPad - Universitas Padjadjaran
41 Hôpital Américain de Paris
42 Pusan National University
43 University of Kent [Canterbury]
44 Lithuanian University of Health Sciences, Lithuania
45 Başkent University Hospital [Adana, Turkey]
46 TUMS - Tehran University of Medical Sciences
47 Unifg - Università degli Studi di Foggia = University of Foggia
48 SQU - Sultan Qaboos University
49 Hamad Medical Corporation [Doha, Qatar]
50 Weill Cornell Medicine [Qatar]
51 Shiraz University - Shiraz University
52 IMU - Innsbruck Medical University = Medizinische Universität Innsbruck
53 Taylor’s University
54 LU - Lebanese University [Beirut]
55 Molinette Hospital
56 UniBuc - University of Bucharest
57 University of Virginia
58 Istanbul Medipol University
59 UM - University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie]
60 JUST - Jordan University of Science and Technology [Irbid, Jordan]
61 UNZA - University of Zambia [Lusaka]
62 Osaka University [Osaka]
63 Hatay Mustafa Kemal University
64 Cairo University - Faculty of Medicine
65 The Chinese University of Hong Kong [Hong Kong]
66 UIC - University of Illinois [Chicago]
67 Lilavati Hospital and Research Centre
68 UNIVPM - Università Politecnica delle Marche [Ancona]
69 Uniklinik - Universitäts Klinikum Freiburg = University Medical Center Freiburg
70 Macquarie University [Sydney]
71 University of Garmian
72 Udayana University [Bali]
73 Istanbul University
74 Ankara Üniversitesi
75 UZ Brussel - Universitair Ziekenhuis Brussel = University Hospital of Brussels
76 Kurukshetra University
77 Clinic Barcelona Hospital Universitari
78 Fundació Puigvert [Barcelona, Spain]
79 Abant Izzet Baysal University - Bolu Abant İzzet Baysal Üniversitesi
80 UNIROMA - Università degli Studi di Roma "La Sapienza" = Sapienza University [Rome]
81 Hammersmith Hospital NHS Imperial College Healthcare
Ashok Agarwal
Connectez-vous pour contacter l'auteur
Cleveland Clinic
Ala’a Farkouh
Cleveland Clinic
Ramadan Saleh
Sohag University
Taha Abo-Almagd Abdel-Meguid Hamoda
King Abdulaziz University
Minia University
Ahmed M Harraz
Mansoura University [Egypt]
Parviz Kavoussi
Mohamed Arafa
Weill Cornell Medical College-Qatar, Qatar
Cairo University
Gianmaria Salvio
Polytechnic University of Marche [Ancona, Italy] / Università Politecnica delle Marche [Ancona, Italia]
Amarnath Rambhatla
Vattikuti Urology Institute
Tuncay Toprak
Murat Gül
Selcuk University [Konya, Turkey]
Nguyen Ho Vinh Phuoc
Florence Boitrelle
CHI Poissy-Saint-Germain
Biologie de la Reproduction, Environnement, Epigénétique & Développement
Ponco Birowo
Cipto Mangunkusumo Hospital [Jakarta]
Ramy Abou Ghayda
Case Western Reserve University, Cleveland
Rossella Cannarella
University of Catania [Italy]
Shinnosuke Kuroda
Cleveland Clinic
Damayanthi Durairajanayagam
Universiti Teknologi MARA [Shah Alam]
Armand Zini
McGill University = Université McGill [Montréal, Canada]
Christine Wyns
Cliniques Universitaires Saint-Luc [Bruxelles]
Selcuk Sarikaya
Gulhane Training and Research Hospital
Kelton Tremellen
Flinders University of South Australia
Taymour Mostafa
Cairo University
Ioannis Sokolakis
Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany.
Donald P Evenson
Ralf Henkel
Imperial College London
University of the Western Cape
Wael Zohdy
Cairo University
Eric Chung
Princess Alexandra Hospital, Brisbane
Imad Ziouziou
Marco Falcone
Molinette Hospital
Giorgio I Russo
Università degli studi di Catania = University of Catania
Manaf Al-Hashimi
Burjeel Hospital
Khalifa University
Aldo E Calogero
University of Catania [Italy]
Edmund Ko
Loma Linda University
Giovanni Colpi
Sheena Lewis
Ege Can Serefoglu
Fahmi Bahar
Biruni University
Marlon Martinez
University of Santo Tomas [Manila, Philippines]
Quang Nguyen
Vietnam National University [Hanoï]
Rafael F Ambar
Mustafa Emre Bakircioglu
Hussein Kandil
Nasser Mogharabian
Shahroud University of Medical Sciences
Marjan Sabbaghian
Royan Institute for Reproductive Biomedicine [Tehran, Iran]
Hisanori Taniguchi
Kansai University
Akira Tsujimura
Hesamoddin Sajadi
Royan Institute for Reproductive Biomedicine [Tehran, Iran]
Wael Ibrahim
Widi Atmoko
Cipto Mangunkusumo Hospital [Jakarta]
Paraskevi Vogiatzi
Sezgin Gunes
Ondokuz Mayis University
Mohammad Ali Sadighi Gilani
Royan Institute for Reproductive Biomedicine [Tehran, Iran]
Shubhadeep Roychoudhury
Assam University
Nur Dokuzeylül Güngör
Bahcesehir University [Istanbul]
Lukman Hakim
Universitas Airlangga
Ricky Adriansjah
Universitas Padjadjaran
Priyank Kothari
Sunil Jindal
Edouard Amar
Hôpital Américain de Paris
Hyun Jun Park
Pusan National University
Tran Quang Tien Long
Sheryl Homa
University of Kent [Canterbury]
Birute Zilaitiene
Lithuanian University of Health Sciences, Lithuania
Israel Maldonado Rosas
Angelo Marino
Edoardo Pescatori
Cevahir Ozer
Başkent University Hospital [Adana, Turkey]
Hamed Akhavizadegan
Tehran University of Medical Sciences
Nicolas Garrido
Gian Maria Busetto
Università degli Studi di Foggia = University of Foggia
Aram Adamyan
Mohamed Al-Marhoon
Sultan Qaboos University
Haitham Elbardisi
Hamad Medical Corporation [Doha, Qatar]
Weill Cornell Medicine [Qatar]
Parisa Dolati
Shiraz University
Mahsa Darbandi
Sara Darbandi
Giancarlo Balercia
Polytechnic University of Marche [Ancona, Italy] / Università Politecnica delle Marche [Ancona, Italia]
Germar-Michael Pinggera
Innsbruck Medical University = Medizinische Universität Innsbruck
Sava Micic
Christopher Chee Kong Ho
Taylor’s University
Mohamad Moussa
Lebanese University [Beirut]
Mirko Preto
Molinette Hospital
Cătălina Zenoaga-Barbăroşie
University of Bucharest
Ryan P Smith
University of Virginia
Raghavender Kosgi
Jean de La Rosette
Istanbul Medipol University
Ahmed I El-Sakka
Saad Mohammed Abumelha
King Abdulaziz University
Tiago Cesar Mierzwa
Teng Aik Ong
University of Malaya = Universiti Malaya [Kuala Lumpur, Malaisie]
Saleem A Banihani
Jordan University of Science and Technology [Irbid, Jordan]
Kasonde Bowa
University of Zambia [Lusaka]
Shinichiro Fukuhara
Osaka University [Osaka]
Luca Boeri
Yavuz Onur Danacıoğlu
Fatih Gokalp
Hatay Mustafa Kemal University
Osama Mohamed Selim
Cairo University - Faculty of Medicine
Chak-Lam Cho
The Chinese University of Hong Kong [Hong Kong]
Nicholas N Tadros
Muhammet Rasit Ugur
Mehmet Serkan Ozkent
Peter Chiu
The Chinese University of Hong Kong [Hong Kong]
Arif Kalkanli
Kareim Khalafalla
Hamad Medical Corporation [Doha, Qatar]
University of Illinois [Chicago]
Ranjit B Vishwakarma
Lilavati Hospital and Research Centre
Federica Finocchi
Università Politecnica delle Marche [Ancona]
Sotiris Andreadakis
Carlo Giulioni
Università Politecnica delle Marche [Ancona]
Gökhan Çeker
Erman Ceyhan
Başkent University Hospital [Adana, Turkey]
Vineet Malhotra
Mehmet Yilmaz
Universitäts Klinikum Freiburg = University Medical Center Freiburg
Massimiliano Timpano
Molinette Hospital
Trenton L Barrett
Shannon Hee Kyung Kim
Macquarie University [Sydney]
Sun-Tae Ahn
Filippo Giacone
Ayad Palani
University of Garmian
Gede Wirya Kusuma Duarsa
Udayana University [Bali]
Ates Kadioglu
Istanbul University
Franco Gadda
Daniel Suslik Zylbersztejn
Kaan Aydos
Ankara Üniversitesi
Deniz Kulaksız
Deepak Gupte
Gokhan Calik
Istanbul Medipol University
Keshab Kumar Karna
Panagiotis Drakopoulos
Universitair Ziekenhuis Brussel = University Hospital of Brussels
Aykut Baser
Vijay Kumar
Kurukshetra University
Juan Manuel Corral Molina
Clinic Barcelona Hospital Universitari
Osvaldo Rajmil
Fundació Puigvert [Barcelona, Spain]
Raphael H Ferreira
Sofia Leonardi
Armen Avoyan
Emrullah Sogutdelen
Abant Izzet Baysal University - Bolu Abant İzzet Baysal Üniversitesi
Giorgio Franco
Università degli Studi di Roma "La Sapienza" = Sapienza University [Rome]
Jonathan Ramsay
Hammersmith Hospital NHS Imperial College Healthcare
Liliana Ramirez
Rupin Shah
Vilvapathy Senguttuvan Karthikeyan
Lilavati Hospital and Research Centre

Abstract

Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF ; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.

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Life Sciences [q-bio]
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Submitted on : Thursday, June 8, 2023-3:32:53 PM

Last modification on : Friday, June 16, 2023-3:34:23 AM

Long-term archiving on: Saturday, September 9, 2023-8:00:37 PM

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hal-04122488 , version 1 (08-06-2023)

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Ashok Agarwal, Ala’a Farkouh, Ramadan Saleh, Taha Abo-Almagd Abdel-Meguid Hamoda, Ahmed M Harraz, et al.. Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations. The World Journal of Men's Health, 2023, 41, ⟨10.5534/wjmh.220282⟩. ⟨hal-04122488⟩

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