Sperm DNA fragmentation − can it be a routine?

Aim: To assess the correlation between semen parameters and sperm DNA fragmentation (SDF) and to examine whether SDF can be recommended as a routine test along with semen analysis. Materials and methods: Retrospective analysis was conducted for 118 male infertile patients attending a fertility clinic obtained from the records between 2017 and 2019. Semen analysis and SDF were assessed according to World Health Organization − 2010 guidelines and sperm chromatin dispersion test, respectively. Patients were grouped based on their SDF scores as “low DNA fragmentation group (LDF)” if SDF ≤ 18% and as “high DNA fragmentation group (HDF)” if SDF > 18%. Mann–Whitney and Kruskal–Wallis tests were used to find the difference in the mean of semen parameters between SDF groups. Statistical analysis was carried out using STATA Version-14. Results: The mean value of sperm concentration, motility, and normal morphology was higher in LDF compared to HDF. Correlation analysis showed patients’ age to be positively associated with SDF (r = 0.125; P = 0.102). Sperm concentration, progressive motility, and normal morphology had a weak negative correlation with SDF. Around 63% and 69% of patients with normal morphology and normal motility respectively had high SDF. In the HDF category, nearly 42% had normal morphology, whereas a 66% demonstrated normal motility. The results of Kruskal–Wallis test for patients who had a treatment outcome (conception) showed that patients in LDF group had 1.5 times higher chance of “conception and live birth.” Conclusion: Men with normal semen parameters can still have a high level of SDF. SDF along with semen analysis can help assess the reproductive potential of a male better.