European Association of Urology Guidelines Panel on Male Sexual and Reproductive Health: A Clinical Consultation Guide on the Indications for Performing Sperm DNA Fragmentation Testing in Men with Infertility and Testicular Sperm Extraction in Nonazoospermic Men

Tharakan, Tharu; Bettocchi, Carlo; Carvalho, Joana; Corona, Giovanni; Jones, T. Hugh; Kadıoğlu, Ateş; Salamanca, Juan; Şerefoğlu, Ege Can; Verze, Paolo; Salonia, Andrea; Minhas, Suks

doi:10.1016/j.euf.2020.12.017

Cited by 47 publications

(60 citation statements)

References 101 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, the addition of a sperm DNA integrity testing to standard semen analysis, albeit still debated, can provide further information on the couple’s chance of spontaneous pregnancy and in selection of method of assisted reproduction [ 14 , 33 , 34 ]. These issues will be further discussed in the following paragraphs.…”

Section: Diagnostic Work Up Of Men From the Infertile Couplementioning

confidence: 99%

The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives

Pallotti

Barbonetti

Rastrelli

et al. 2022

J Endocrinol Invest

View full text Add to dashboard Cite

Purpose The current clinical practice in reproductive medicine should pose the couple at the centre of the diagnostic–therapeutic management of infertility and requires intense collaboration between the andrologist, the gynaecologist and the embryologist. The andrologist, in particular, to adequately support the infertile couple, must undertake important biological, psychological, economical and ethical task. Thus, this paper aims to provide a comprehensive overview of the multifaceted role of the andrologist in the study of male factor infertility. Methods A comprehensive Medline, Embase and Cochrane search was performed including publications between 1969 and 2021. Results Available evidence indicates that a careful medical history and physical examination, followed by semen analysis, always represent the basic starting points of the diagnostic work up in male partner of an infertile couple. Regarding treatment, gonadotropins are an effective treatment in case of hypogonadotropic hypogonadism and FSH may be used in men with idiopathic infertility, while evidence supporting other hormonal and nonhormonal treatments is either limited or conflicting. In the future, pharmacogenomics of FSHR and FSHB as well as innovative compounds may be considered to develop new therapeutic strategies in the management of infertility. Conclusion To provide a high-level of care, the andrologist must face several critical diagnostical and therapeutical steps. Even though ART may be the final and decisive stage of this decisional network, neglecting to treat the male partner may ultimately increase the risks of negative outcome, as well as costs and psychological burden for the couple itself.

show abstract

Section: Diagnostic Work Up Of Men From the Infertile Couplementioning

confidence: 99%

The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives

Pallotti

Barbonetti

Rastrelli

et al. 2022

J Endocrinol Invest

View full text Add to dashboard Cite

show abstract

“…The European Academy of Andrology (EAA) suggest adding SDF testing to initial basic semen analysis in men with oligoasthenoteratozoospermia who are considered for ART [ 22 ]. The European Association of Urology (EAU) recommend SDF testing only for men with unexplained infertility or after RPL [ 23 ]. Recently, the American Urological Association (AUA) and American Society for Reproductive Medicine (ASRM) published a guideline on male infertility and they recommend against SDF testing in initial evaluation of fertility, but advocate its use and importance in couples experiencing RPL [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines

Agarwal

Farkouh

Parekh

et al. 2022

World J Mens Health

View full text Add to dashboard Cite

Sperm DNA fragmentation (SDF) is implicated in male infertility and adverse reproductive outcomes. With the publication of many studies regarding the etiologies and contributors to SDF, as well as the effects of SDF, guidelines are necessary to aid clinicians in the application of SDF for male fertility evaluation. Two recent clinical practice guidelines were published by Agarwal et al and Esteves et al. In this article, we have evaluated and compared both guidelines. We have found fairly similar recommendations between the two guidelines and have also highlighted the differences between them. Finally, we have summarized and combined the best practice recommendations from both guidelines.

show abstract

“…While surgical sperm retrieval is an effective method for helping couples with azoospermia conceive, there is also evidence that using testicular and/or epididymal sperm for ICSI may enhance outcomes for couples in which the male partner has an abnormal ejaculated sperm DNA fragmentation (SDF) [ 62 , 63 , 64 , 65 , 66 , 67 ]. An elevated SDF has been associated with many adverse reproductive outcomes, including lower natural pregnancy rates, lower ART pregnancy rates (including IUI, IVF, and ICSI), abnormal embryo development, and a greater likelihood of recurrent pregnancy loss [ 68 , 69 , 70 ]. Though many conditions have been associated with an elevated SDF—including environmental factors (i.e., cigarette smoking, radiation, chemotherapy, heat exposure, and medications), pathologic conditions (i.e., varicocele, malignancy, infections, obesity, chronic illness), and even iatrogenic causes (i.e., sperm cryopreservation)—these conditions may lead to DNA damage through similar molecular mechanisms [ 70 , 71 ].…”

Section: Surgical Management Of Male Infertilitymentioning

confidence: 99%

Microsurgical Management of Male Infertility: Compelling Evidence That Collaboration with Qualified Male Reproductive Urologists Enhances Assisted Reproductive Technology (ART) Outcomes

Marinaro

Goldstein

2022

JCM

View full text Add to dashboard Cite

A male factor plays a significant role in a couple’s reproductive success. Today, advances in reproductive technology, such as intracytoplasmic sperm injection (ICSI), have allowed it to be possible for just a single sperm to fertilize an egg, thus, overcoming many of the traditional barriers to male fertility, such as a low sperm count, impaired motility, and abnormal morphology. Given these advances in reproductive technology, it has been questioned whether a reproductive urologist is needed for the evaluation and treatment of infertile and subfertile men. In this review, we aim to provide compelling evidence that collaboration between reproductive endocrinologists and reproductive urologists is essential for optimizing a couple’s fertility outcomes, as well as for improving the health of infertile men and providing cost-effective care.

show abstract

European Association of Urology Guidelines Panel on Male Sexual and Reproductive Health: A Clinical Consultation Guide on the Indications for Performing Sperm DNA Fragmentation Testing in Men with Infertility and Testicular Sperm Extraction in Nonazoospermic Men

Cited by 47 publications

References 101 publications

The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives

The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives

Sperm DNA Fragmentation: A Critical Assessment of Clinical Practice Guidelines

Microsurgical Management of Male Infertility: Compelling Evidence That Collaboration with Qualified Male Reproductive Urologists Enhances Assisted Reproductive Technology (ART) Outcomes

Contact Info

Product

Resources

About