Sperm DNA Fragmentation and Male Infertility: A Comprehensive Review

Male infertility remains a critical concern in reproductive medicine, with sperm DNA fragmentation (SDF) emerging as a key factor in impaired fertility potential. This review compiles and critically examines current literature on the biological mechanisms, diagnostic approaches, and clinical significance of SDF. The paper explores how oxidative stress, apoptosis, and defective chromatin packaging contribute to DNA damage in sperm cells. Various diagnostic tools such as TUNEL, SCSA, Comet assay, and SCD test are reviewed in terms of reliability and clinical relevance. The role of SDF in natural conception, intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) is also discussed. Furthermore, the review addresses therapeutic interventions ranging from lifestyle modifications and antioxidant therapy to the application of advanced sperm selection techniques. It was observed that high levels of SDF are associated with lower fertilization rates, poor embryo quality, increased miscarriage risk, and reduced pregnancy outcomes. Recognizing and managing SDF could significantly enhance reproductive success and guide patient-specific fertility treatment.