Cho Chak-Lam, Agarwal Ashok, Majzoub Ahmad, Esteves Sandro C
Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China.
American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
Transl Androl Urol. 2017 Sep;6(Suppl 4):S366-S373. doi: 10.21037/tau.2017.07.28.
Sperm DNA integrity is generally acknowledged as an essential component for human reproduction. While the negative impact of high sperm DNA fragmentation (SDF) on outcomes of natural pregnancy and assisted reproductive technology (ART) is well known, the clinical indication of SDF testing is less well defined. A recent review on clinical utility of SDF testing highlighted the different SDF assays and clinical indications of SDF testing. This concise practice recommendations aim at summarizing the evidence and presenting to the readers the essence of the clinical utility of SDF testing based on the currently existing evidence. The potential role of SDF testing in varicocelectomy candidates, couples with recurrent pregnancy loss, patients with unexplained infertility, couples with failed assisted reproduction, and infertile men with exposure to modifiable lifestyle risk factors is illustrated. Recommendations from an expert panel on each clinical condition is presented, with levels of evidence.
精子DNA完整性通常被认为是人类生殖的一个重要组成部分。虽然高精子DNA碎片率（SDF）对自然妊娠和辅助生殖技术（ART）结局的负面影响已为人熟知，但SDF检测的临床指征尚不太明确。最近一篇关于SDF检测临床应用的综述强调了不同的SDF检测方法和SDF检测的临床指征。本简明实践建议旨在总结现有证据，并向读者呈现基于目前现有证据的SDF检测临床应用的本质。阐述了SDF检测在精索静脉曲张手术候选者、复发性流产夫妇、不明原因不孕症患者、辅助生殖失败夫妇以及暴露于可改变生活方式风险因素的不育男性中的潜在作用。给出了专家小组针对每种临床情况的建议及证据等级。
