FERTILITY: Edited by Aydin AriciSperm DNA damage how relevant is it clinically?Beshay, Victor E.; Bukulmez, OrhanAuthor Information Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas, USA Correspondence to Orhan Bukulmez, MD, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9032, USA. Tel: +1 214 648 4747; fax: +1 214 648 8066; e-mail: Orhan.Bukulmez@UTSouthwestern.edu Current Opinion in Obstetrics and Gynecology: June 2012 - Volume 24 - Issue 3 - p 172-179 doi: 10.1097/GCO.0b013e32835211b5 Buy Metrics Abstract Purpose of review The true impact of the current sperm DNA fragmentation testing needs further scrutiny to assess whether clinically meaningful information is conveyed. Recent findings Various studies have suggested different or no threshold values with assorted tests for the percentage of DNA fragmentation in the ejaculated sperm above which natural conception, fertilization or embryo development and/or clinical pregnancy rates are compromised. Current DNA fragmentation assessment methods provide very little specific information on the nature and severity of the DNA damage detected. Although sperm DNA fragmentation is associated with lower pregnancy rates through natural conception or intrauterine insemination, it does not seem to affect intracytoplasmic sperm injection outcome. Although animal studies demonstrated adverse reproductive effects of sperm DNA fragmentation, any conclusive evidence in humans is yet to be demonstrated. It is not clear whether interventions aimed at enrichment of sperm with decreased DNA fragmentation are effective in preventing the potential adverse effects of sperm DNA fragmentation in humans. Major concern about the use of sperm DNA integrity tests as prognostic parameters is that the direct evaluation of DNA fragmentation in individual sperm fertilizing the oocyte is not possible. Summary The lack of consensus in defining a clinically relevant standard DNA fragmentation test with a meaningful cut-off level brings challenges in implementing the routine use of sperm DNA integrity assessment in daily practice. © 2012 Lippincott Williams & Wilkins, Inc.