Male factors may be present in up to 50-70% of infertile couples and the prevalence of male infertility accounts for 20-30% of infertility cases. Understanding the mechanisms and causes behind male infertility remains a challenge, but new diagnostic tools such as DNA fragmentation might aid in cases where the routine semen analysis is insufficient. DNA fragmentation, which refers to damages or breaks of the genetic material of the spermatozoa, is considered one of the main causes of male infertility due to impaired functional capability of sperm. The aim of the present narrative review is to investigate and enlighten the potential correlation between DNA fragmentation and male infertility parameters such as the seminal profile and the reproductive outcomes. Comprehensive research in PubMed/Medline and Scopus databases was conducted and 28 studies were included in the present review. Fourteen studies provided data regarding the impact of DNA fragmentation and seminal parameters and showed a correlation of significantly lower sperm count, lower concentration, motility, and abnormal morphology with an increased DNA fragmentation index (DFI). Similarly, 15 studies provided data regarding the impact of DFI on reproductive outcomes. Two studies showed higher aneuploidy rates with higher DFI values, and seven studies showed significantly lower pregnancy rates and live birth rates with higher DFI values. Ultimately, the studies included in this review highlight, collectively, the importance of measuring sperm DFI in the assessment of male infertility. Further studies are needed to explore the effectiveness of interventions aiming to reduce DFI levels.
International journal of molecular sciences. 2024 Sep 22*** epublish ***
Sofoklis Stavros, Anastasios Potiris, Ermioni Molopodi, Despoina Mavrogianni, Athanasios Zikopoulos, Konstantinos Louis, Theodoros Karampitsakos, Eleni Nazou, Dimdos Sioutis, Chrysi Christodoulaki, Charikleia Skentou, Angeliki Gerede, Athanasios Zachariou, Panagiotis Christopoulos, Periklis Panagopoulos, Ekaterini Domali, Peter Drakakis
Third Department of Obstetrics and Gynecology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece., Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece., First Department of Obstetrics and Gynecology, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece., Department of Obstetrics and Gynecology, Chania General Hospital "St. George", 73300 Chania, Greece., Department of Obstetrics and Gynecology, Medical School of the University of Ioannina, 45110 Ioannina, Greece., Department of Obstetrics and Gynecology, Democritus University of Thrace, 69100 Campus, Greece., Department of Urology, School of Medicine, Ioannina University, 45110 Ioannina, Greece., Second Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece.