Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Author:

Agarwal Ashok12ORCID,Farkouh Ala’a1ORCID,Saleh Ramadan13ORCID,Hamoda Taha Abo-Almagd Abdel-Meguid145ORCID,Salvio Gianmaria16ORCID,Boitrelle Florence178ORCID,Harraz Ahmed M.191011ORCID,Ghayda Ramy Abou112ORCID,Kavoussi Parviz113ORCID,Gül Murat114ORCID,Toprak Tuncay115ORCID,Russo Giorgio Ivan116ORCID,Durairajanayagam Damayanthi117ORCID,Rambhatla Amarnath118ORCID,Birowo Ponco119ORCID,Cannarella Rossella12021ORCID,Phuoc Nguyen Ho Vinh12223ORCID,Zini Armand124ORCID,Arafa Mohamed1252627ORCID,Wyns Christine128ORCID,Tremellen Kelton129ORCID,Sarıkaya Selçuk130ORCID,Lewis Sheena131ORCID,Evenson Donald P.132ORCID,Ko Edmund133ORCID,Calogero Aldo E.110ORCID,Bahar Fahmi134ORCID,Martínez Marlon135ORCID,Ambar Rafael F.13637ORCID,Colpi Giovanni M.138ORCID,Bakircioglu Mustafa Emre139ORCID,Henkel Ralf14041ORCID,Kandil Hussein142ORCID,Serefoglu Ege Can143ORCID,Alfakhri Abdullah144ORCID,Tsujimura Akira145ORCID,Kheradmand Alireza146ORCID,Marino Angelo147ORCID,Adamyan Aram148ORCID,Zilaitiene Birute149ORCID,Ozer Cevahir150ORCID,Pescatori Edoardo151ORCID,Vogiatzi Paraskevi152ORCID,Busetto Gian Maria153ORCID,Balercia Giancarlo16ORCID,Elbardisi Haitham1252654ORCID,Akhavizadegan Hamed155ORCID,Sajadi Hesamoddin156ORCID,Taniguchi Hisanori157ORCID,Park Hyun Jun15859ORCID,Maldonado Rosas Israel160ORCID,Al-Marhoon Mohamed161ORCID,Sadighi Gilani Mohammad Ali156ORCID,Alhathal Naif162ORCID,Quang Nguyen16364ORCID,Pinggera Germar-Michael165ORCID,Kothari Priyank166ORCID,Micic Sava167ORCID,Homa Sheryl168ORCID,Long Tran Quang Tien169ORCID,Zohdy Wael127ORCID,Atmoko Widi119ORCID,Ibrahim Wael170ORCID,Sabbaghian Marjan156ORCID,Abumelha Saad Mohammed171ORCID,Chung Eric172ORCID,Ugur Muhammet Rasit173ORCID,Ozkent Mehmet Serkan174ORCID,Selim Osama127ORCID,Darbandi Mahsa17576ORCID,Fukuhara Shinichiro177ORCID,Jamali Mounir178ORCID,de la Rosette Jean179ORCID,Kuroda Shinnosuke21ORCID,Smith Ryan P.180ORCID,Baser Aykut181ORCID,Kalkanli Arif182ORCID,Tadros Nicholas N.183ORCID,Aydos Kaan184ORCID,Mierzwa Tiago Cesar185ORCID,Khalafalla Kareim1258687ORCID,Malhotra Vineet188ORCID,Moussa Mohamad18990ORCID,Finocchi Federica16ORCID,Rachman Rinaldo Indra119ORCID,Giulioni Carlo16ORCID,Avidor-Reiss Tomer19192ORCID,Kahraman Oguzhan151ORCID,Çeker Gökhan93ORCID,Zenoaga-Barbăroşie Cătălina194ORCID,Barrett Trenton L.195ORCID,Yilmaz Mehmet196ORCID,Kadioglu Ates197ORCID,Jindal Sunil198ORCID,Omran Huda199ORCID,Bocu Kadir1100ORCID,Karthikeyan Vilvapathy Senguttuvan1101ORCID,Franco Giorgio1102ORCID,Solorzano Jesús Fernando160ORCID,Vishwakarma Ranjit B.1103ORCID,Arianto Eko1104ORCID,Garrido Nicolas1105ORCID,Jain Divyanu1106ORCID,Gherabi Nazim1107ORCID,Sokolakis Ioannis1108ORCID,Palani Ayad1109ORCID,Calik Gokhan179ORCID,Kulaksiz Deniz1110ORCID,Simanaviciene Vaida1111ORCID,Simopoulou Mara1112ORCID,Güngör Nur Dokuzeylül1113ORCID,Blecher Gideon1114ORCID,Falcone Marco1115ORCID,Jezek Davor1116ORCID,Preto Mirko1115ORCID,Amar Edouard1117ORCID,Le Tan V.12223ORCID,Ahn Sun Tae1118ORCID,Rezano Andri1119ORCID,Singh Keerti1120ORCID,Rocco Lucia1121ORCID,Savira Missy119ORCID,Rajmil Osvaldo1122ORCID,Darbandi Sara17576ORCID,Sogutdelen Emrullah1123ORCID,Boeri Luca1124ORCID,Hernández Guadalupe1125ORCID,Hakim Lukman1126ORCID,Morimoto Yoshiharu1127ORCID,Japari Andrian1128ORCID,Sofikitis Nikolaos1129ORCID,Altay Baris1130ORCID,Metin Mahmutoglu Asli1131ORCID,Al Hashimi Manaf1132ORCID,Ziouziou Imad1133ORCID,Anagnostopoulou Christina1134ORCID,Lin Haocheng1135ORCID,Shah Rupin1103ORCID

Affiliation:

1. Global Andrology Forum, Moreland Hills, OH, USA.

2. Cleveland Clinic, Cleveland, OH, USA.

3. Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.

4. Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.

5. Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt.

6. Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy.

7. Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.

8. Department of Biology, Reproduction, Epigenetics, Environment, and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France.

9. Urology and Nephrology Center, Mansoura, Egypt.

10. Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait.

11. Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait.

12. Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA.

13. Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA.

14. Department of Urology, Selçuk University School of Medicine, Konya, Turkey.

15. Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.

16. Urology Section, University of Catania, Catania, Italy.

17. Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia.

18. Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA.

19. Department of Urology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

20. Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.

21. Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

22. Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam.

23. Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.

24. Department of Surgery, McGill University, Montreal, QC, Canada.

25. Department of Urology, Hamad Medical Corporation, Doha, Qatar.

26. Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar.

27. Department of Andrology and STDs, Cairo University, Cairo, Egypt.

28. Department of Gynaecology-Andrology, Cliniques Universitaires Saint-Luc, Universitat Catholique de Louvain, Brussels, Belgium.

29. Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia.

30. Department of Urology, Galhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey.

31. Examen Lab Ltd., Northern Ireland, UK.

32. SCSA Diagnostics, Brookings, SD, USA.

33. Department of Urology, Loma Linda University Health, Loma Linda, CA, USA.

34. Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia.

35. Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines.

36. Department of Urology, Centro Universitario em Saude do ABC, Santo Andre, Brazil.

37. Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo Andre, Brazil.

38. Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland.

39. SENSART Clinic, Urology, Fulya, Istanbul, Turkey.

40. Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.

41. Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.

42. Fakih IVF Fertility Center, Abu Dhabi, UAE.

43. Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.

44. Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia.

45. Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan.

46. Department of Urology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

47. Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy.

48. IVF Department, Astghik Medical Center, Yerevan, Armenia.

49. Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

50. Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey.

51. Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy.

52. Andromed Health & Reproduction, Fertility & Reproductive Health Diagnostic Center, Athens, Greece.

53. Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy.

54. Department of Urology, College of Medicine, Qatar University, Doha, Qatar.

55. Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran.

56. Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

57. Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan.

58. Department of Urology, Pusan National University School of Medicine, Busan, Korea.

59. Medical Research Institute of Pusan National University Hospital, Busan, Korea.

60. IVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico.

61. Division of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Sultanate of Oman.

62. King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

63. Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam.

64. Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.

65. Department of Urology, Innsbruck Medical University, Innsbruck, Austria.

66. Department of Urology, Topiwala National Medical College, B.Y.L Nair Ch Hospital, Mumbai, India.

67. Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia.

68. Department of Biosciences, University of Kent, Canterbury, UK.

69. Department of Obstetrics and Gynecology, Hanoi Obstetric and Gynecology Hospital, Hanoi, Vietnam.

70. Department of Surgery, School of Medicine, Taylor’s University, Subang Jaya, Selangor, Malaysia.

71. Division of Urology, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

72. Department of Urology, University of Queensland, Princess Alexandra Hospital, Brisbane QLD, Australia.

73. IVF Michigan, Bloomfield Hills, MI, USA.

74. Department of Urology, Konya City Hospital, Konya, Turkey.

75. Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran.

76. Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran.

77. Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan.

78. Department of Urology, Mohammed V Military Hospital, Rabat, Morocco.

79. Department of Urology, Istanbul Medipol University, Istanbul, Turkey.

80. Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA.

81. Department of Urology, Bandirma Onyedi Eylül University, Balikesir, Turkey.

82. Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey.

83. Division of Urology, Southern Illinois University, Springfield, IL, USA.

84. Department of Urology, Ankara University, Ankara, Turkey.

85. Androlab, Fertility Clinic, Curitiba, PR, Brazil.

86. Department of Urology, University of Texas McGovern Medical School, Houston, TX, USA.

87. Department of Urology, MD Anderson Cancer Center, Houston, TX, USA.

88. Department of Urology, SCM Clinic and Hospital, New Delhi, India.

89. Department of Urology, Lebanese University, Beirut, Lebanon.

90. Department of Urology, Al Zahraa Hospital, UMC, Lebanon.

91. Department of Biological Sciences, University of Toledo, Toledo, OH, USA.

92. Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA.

93. Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.

94. Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania.

95. Department of Urology, Perth Urology Clinic, Murdoch, WA, Australia.

96. Asklepios Klinik Triberg, Urology, Triberg, Germany.

97. Section of Andrology, Department of Urology, Istanbul University, Istanbul, Turkey.

98. Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India.

99. Molecular Genetics Department, Pulse Health Training Center, Manama, Bahrain.

100. Department of Urology, Silopi State Hospital, Sirnak, Turkey.

101. Andrology Unit, Department of Urology, Apollo Hospitals, Greams Road, Chennai, India.

102. Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.

103. Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India.

104. Department of Surgery, Prof. Dr. R.D. Kandou Central General Hospital, Manado, Indonesia.

105. IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.

106. Department of Obstetrics and Gynecology, Jaipur Golden Hospital, New Delhi, India.

107. Department of Medicine, University of Algiers 1, Algiers, Algeria.

108. 2nd Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.

109. Research Centre, University of Garmian, Kalar, Iraq.

110. Department of Obstetrics and Gynecology, University of Health Sciences Kanuni Training and Research Hospital, Trabzon, Turkey.

111. Fertility Centre, Northway Medical Centre, Vilnius, Lithuania.

112. Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

113. Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey.

114. Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia.

115. Department of Urology, Molinette Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy.

116. Reproductive Tissue Bank, Department for Transfusion Medicine and Transplantation Biology, University Hospital Zagreb, Zagreb, Croatia.

117. American Hospital of Paris, Paris, France.

118. Department of Urology, Korea University College of Medicine, Seoul, Korea.

119. Department of Biomedical Sciences, Division of Cell Biology, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia.

120. Department of Preclinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, St Michael, Barbados, Italy.

121. Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta, Italy.

122. Department of Andrology, Fundacio Puigvert, Barcelona, Spain.

123. Department of Urology, Bolu Abant Izzet Baysal University, Bolu, Turkey.

124. Department of Urology, IRCCS Fondazione Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy.

125. IVF Department, CITMER Reproductive Medicine, Puebla, Mexico.

126. Department of Urology, Faculty of Medicine, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia.

127. Department of Urology, HORAC Grand Front Osaka Clinic, Osaka, Japan.

128. Department of Urology, Fertility Clinic, Telogorejo Hospital, Central Java, Indonesia.

129. Department of Urology, Ioannina University School of Medicine, Ioannina, Greece.

130. Department of Urology, Ege University, Izmir, Turkey.

131. Departmant of Medical Biology, Faculty of Medical, Yozgat Bozok University, Yozgat, Turkey.

132. Department of Urology, Burjeel Hospital, Abu Dhabi, UAE.

133. Department of Urology, University Hospital of Souss Massa, Massa, Morocco.

134. Unit of Reproductive Medicine, EmbryoART, Leto Maternity Hospital, Athens, Greece.

135. Department of Urology, Peking University Third Hospital, Beijing, China.

Publisher

XMLink

Subject

Pharmacology (medical),Urology,Psychiatry and Mental health,Public Health, Environmental and Occupational Health,Health Policy,Aging,Reproductive Medicine

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