Marinaro Jessica, Schlegel Peter N
Department of Urology, Weill Cornell Medicine, New York, NY, USA.
New York Mens Health Medical, New York, NY, USA.
Adv Exp Med Biol. 2025;1469:305-332. doi: 10.1007/978-3-031-82990-1_13.
Elevated levels of sperm deoxyribonucleic acid (DNA) fragmentation (SDF) have been associated with several adverse reproductive outcomes, including: lower natural and assisted reproductive technology (ART) pregnancy rates, abnormal embryo development, and recurrent pregnancy loss. However, due to conflicting study results, limited high-level evidence, multiple clinically available assays, and variable standard reference ranges, precisely how SDF testing should be applied to the evaluation and treatment of infertile men remains controversial. To better understand SDF and its role in clinical practice, this chapter aims to: (1) review the literature that has made SDF such a controversial topic, (2) discuss newly published evidence contributing to this complex discussion, and (3) outline the most recent practice guidelines currently available.
精子脱氧核糖核酸（DNA）碎片化（SDF）水平升高与多种不良生殖结局相关，包括：自然受孕和辅助生殖技术（ART）妊娠率降低、胚胎发育异常以及复发性流产。然而，由于研究结果相互矛盾、高级别证据有限、临床上有多种可用检测方法以及标准参考范围各异，SDF检测究竟应如何应用于不育男性的评估和治疗仍存在争议。为了更好地理解SDF及其在临床实践中的作用，本章旨在：（1）回顾使SDF成为一个有争议话题的文献，（2）讨论有助于这一复杂讨论的新发表证据，以及（3）概述目前可用的最新实践指南。
