Portal de investigación
Controversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Farkouh, A
- Agarwal, A
- Hamoda, TAAAM
- Kavoussi, P
- Saleh, R
- Zini, A
- Arafa, M
- Harraz, AM
- Gul, M
- Karthikeyan, VS
- Durairajanayagam, D
- Rambhatla, A
- Boitrelle, F
- Chung, E
- Birowo, P
- Toprak, T
- Abou Ghayda, R
- Cannarella, R
- Phuoc, NHV
- Dimitriadis, F
- Russo, G
- Sokolakis, I
- Mostafa, T
- Makarounis, K
- Ziouziou, I
- Kuroda, S
- Bendayan, M
- Kaiyal, RS
- Japari, A
- Simopoulou, M
- Rocco, L
- Gherabi, N
- Bocu, K
- Kahraman, O
- Le, T
- Wyns, C
- Tremellen, K
- Sarikaya, S
- Lewis, S
- Evenson, DP
- Ko, E
- Calogero, AE
- Bahar, F
- Martinez, M
- Crafa, A
- Nguyen, Q
- Ambar, RF
- Colpi, G
- Bakircioglu, ME
- Henkel, R
- Kandil, H
- Serefoglu, EC
- Alarbid, A
- Tsujimura, A
- Kheradmand, A
- Anagnostopoulou, C
- Marino, A
- Adamyan, A
- Zilaitiene, B
- Ozer, C
- Pescatori, E
- Vogiatzi, P
- Busetto, GM
- Balercia, G
- Elbardisi, H
- Akhavizadegan, H
- Sajadi, H
- Taniguchi, H
- Park, HJ
- Rosas, IM
- Al-Marhoon, M
- Gilani, MAS
- Alhathal, N
- Pinggera, GM
- Kothari, P
- Mogharabian, N
- Micic, S
- Homa, S
- Darbandi, S
- Long, TQT
- Zohdy, W
- Atmoko, W
- Sabbaghian, M
- Ibrahim, W
- Smith, RP
- Ho, CCK
- de la Rosette, J
- El-Sakka, AI
- Preto, M
- Zenoaga-Barbarosie, C
- Abumelha, SM
- Baser, A
- Aydos, K
- Ramirez-Dominguez, L
- Kumar, V
- Ong, TA
- Mierzwa, TC
- Adriansjah, R
- Banihani, SA
- Bowa, K
- Fukuhara, S
- Peña, MR
- Moussa, M
- Ari, UÇ
- Cho, CL
- Tadros, NN
- Ugur, MR
- Amar, E
- Falcone, M
- Santer, FR
- Kalkanli, A
- Karna, KK
- Khalafalla, K
- Vishwakarma, RB
- Finocchi, F
- Giulioni, C
- Ceyhan, E
- Çeker, G
- Yazbeck, C
- Rajmil, O
- Yilmaz, M
- Altay, B
- Barrett, TL
- Ngoo, KS
- Roychoudhury, S
- Salvio, G
- Lin, HC
- Kadioglu, A
- Timpano, M
- Avidor-Reiss, T
- Hakim, L
- Sindhwani, P
- Franco, G
- Singh, R
- Giacone, F
- Ruzaev, M
- Kosgi, R
- Sofikitis, N
- Palani, A
- Calik, G
- Kulaksiz, D
- Jezek, D
- Al Hashmi, M
- Drakopoulos, P
- Omran, H
- Leonardi, S
- Celik-Ozenci, C
- Güngör, ND
- Ramsay, J
- Amano, T
- Sogutdelen, E
- Duarsa, GWK
- Chiba, K
- Jindal, S
- Savira, M
- Boeri, L
- Borges, E
- Gupte, D
- Gokalp, F
- Hebrard, GH
- Minhas, S
- Shah, R
- Global Andrology Forum
Grupos
Abstract
Purpose: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproduc-tive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods: An online global survey on clinical practices related to SDF was disseminated to reproductive clini-cians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formu-lated and adapted using the Delphi method.Results: A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4-6 months and 38.1% recommend 3 months. For men with unex-plained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respon-dents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical vari-cocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated.Conclusions: This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians.
Datos de la publicación
- ISSN/ISSNe:
- 2287-4208, 2287-4690
- Tipo:
- Article
- Páginas:
- 809-847
- DOI:
- 10.5534/wjmh.230008
- PubMed:
- 37118965
- Factor de Impacto:
- 0,788 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
World Journal of Mens Health KOREAN SOC SEXUAL MEDICINE & ANDROLOGY
Citas Recibidas en Web of Science: 23
Documentos
- No hay documentos
Filiaciones
Keywords
- Delphi method; Disease management; DNA fragmentation; Male infertility; Practice guideline; Survey
Cita
Farkouh A,Agarwal A,Hamoda T,Kavoussi P,Saleh R,Zini A,Arafa M,Harraz AM,Gul M,Karthikeyan VS,Durairajanayagam D,Rambhatla A,Boitrelle F,Chung E,Birowo P,Toprak T,Abou R,Cannarella R,Phuoc NHV,Dimitriadis F,Russo G,Sokolakis I,Mostafa T,Makarounis K,Ziouziou I,Kuroda S,Bendayan M,Kaiyal RS,Japari A,Simopoulou M,Rocco L,GARRIDO N,Gherabi N,Bocu K,Kahraman O,Le T,Wyns C,Tremellen K,Sarikaya S,Lewis S,Evenson DP,Ko E,Calogero AE,Bahar F,Martinez M,Crafa A,Nguyen Q,Ambar RF,Colpi G,Bakircioglu ME,Henkel R,Kandil H,Serefoglu EC,Alarbid A,Tsujimura A,Kheradmand A,Anagnostopoulou C,Marino A,Adamyan A,Zilaitiene B,Ozer C,Pescatori E,Vogiatzi P,Busetto GM,Balercia G,Elbardisi H,Akhavizadegan H,Sajadi H,Taniguchi H,Park HJ,Rosas IM,Al M,Gilani M,Alhathal N,Pinggera GM,Kothari P,Mogharabian N,Micic S,Homa S,Darbandi S,Long TQT,Zohdy W,Atmoko W,Sabbaghian M,Ibrahim W,Smith RP,Ho CCK,de la Rosette J,El AI,Preto M,Zenoaga C,Abumelha SM,Baser A,Aydos K,Ramirez L,Kumar V,Ong TA,Mierzwa TC,Adriansjah R,Banihani SA,Bowa K,Fukuhara S,Peña MR,Moussa M,Ari UÇ,Cho CL,Tadros NN,Ugur MR,Amar E,Falcone M,Santer FR,Kalkanli A,Karna KK,Khalafalla K,Vishwakarma RB,Finocchi F,Giulioni C,Ceyhan E,Çeker G,Yazbeck C,Rajmil O,Yilmaz M,Altay B,Barrett TL,Ngoo KS,Roychoudhury S,Salvio G,Lin HC,Kadioglu A,Timpano M,Avidor T,Hakim L,Sindhwani P,Franco G,Singh R,Giacone F,Ruzaev M,Kosgi R,Sofikitis N,Palani A,Calik G,Kulaksiz D,Jezek D,Al Hashmi M,Drakopoulos P,Omran H,Leonardi S,Celik C,Güngör ND,Ramsay J,Amano T,Sogutdelen E,Duarsa GWK,Chiba K,Jindal S,Savira M,Boeri L,Borges E,Gupte D,Gokalp F,Hebrard GH,Minhas S,Shah R,Global F. Controversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations. World J. Men's Health. 2023. 41. (4):p. 809-847. IF:4,000. (1).