Pharmacological and technological advances in managing sperm DNA fragmentation: Implications for male fertility: A systematic review

Male infertility continues to pose a significant clinical issue, and sperm DNA fragmentation (SDF) has also been established as a key marker of fertilization success, embryo viability, and pregnancy outcomes. The assessment of sperm DNA integrity using conventional semen analysis proves inadequate, creating the imperative for implementing innovative therapeutic approaches. This review examines the impact of SDF on reproductive outcomes and pharmacologic management through the use of antioxidants, hormone treatments, and amino acid therapies for preventing DNA damage. Antioxidants such as Vitamins C and E, coenzyme Q10, selenium, and L-carnitine are essential in countering oxidative stress. At the same time, hormonal agents such as clomiphene citrate and gonadotropins regulate endocrine function to facilitate spermatogenesis. Amino acids such as L-arginine and N-acetylcysteine also contribute to sperm metabolism and antioxidative defense mechanisms. In addition, novel technologies such as nanotechnology-based drug delivery systems, enhanced sperm selection methods, and gene editing tools offer new pathways for enhancing sperm DNA integrity. However, their clinical efficacy requires further validation. Despite the potential benefits of pharmacologic interventions, inconsistencies in treatment effectiveness, dosing regimens, and study methodologies necessitate the development of standardized protocols and large-scale clinical trials. Integrating these therapeutic approaches with innovative technologies is essential for optimizing treatment and improving reproductive outcomes.