Contributors: Cleveland Clinic; King Abdulaziz University; Minia University; Sohag University; McGill University = Université McGill Montréal, Canada; Hamad Medical Corporation Doha, Qatar; Cairo University; Weill Cornell Medicine Qatar; Mansoura University Egypt; Faculty of Medicine Selcuk University Konya, Turkey; Selçuk University = Selçuk Üniversitesi; Apollo Hospital, Bilaspur(C. G.), India; Universiti Teknologi MARA Shah Alam (UiTM ); Vattikuti Urology Institute; Henry Ford Hospital; CHI Poissy-Saint-Germain; Biologie de la Reproduction, Environnement, Epigénétique & Développement (BREED); École nationale vétérinaire d'Alfort (ENVA)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE); Princess Alexandra Hospital, Brisbane; Cipto Mangunkusumo Hospital Jakarta; Case Western Reserve University Cleveland; Università degli studi di Catania = University of Catania (Unict); Aristotle University of Thessaloniki; Université Ibn Zohr Agadir; Centre d’Études et de Conservation des Œufs et du Sperme CHU Jean Verdier (CECOS); Hôpital Jean Verdier AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); National and Kapodistrian University of Athens (NKUA); Università degli studi della Campania "Luigi Vanvitelli" = University of the Study of Campania Luigi Vanvitelli; University of Algiers 3 : Université d' Alger 3; Başkent University Hospital Adana, Turkey; Université Catholique de Louvain = Catholic University of Louvain (UCL); Flinders University of South Australia; Gulhane Training and Research Hospital; Loma Linda University; University of Santo Tomas Manila, Philippines; Vietnam National University Hanoï (VNU); Imperial College London; University of the Western Cape (UWC); Biruni University Istanbul (BU); Ahvaz Jundishapur University of Medical Sciences (AJUMS); Lithuanian University of health Sciences (LSMU); Baskent University; Università degli Studi di Foggia = University of Foggia (Unifg); Polytechnic University of Marche Ancona, Italy / Università Politecnica delle Marche Ancona, Italia (UNIVPM); Hamad medical corporation; Tehran University of Medical Sciences (TUMS); Royan Institute for Reproductive Biomedicine Tehran, Iran; Kansai Medical University; Pusan National University (PNU); Sultan Qaboos University (SQU); King Faisal Specialist Hospital and Research Centre (KFSH & RC); Innsbruck Medical University = Medizinische Universität Innsbruck (IMU); Dept. of Microbiology, Topiwala National Medical College and B. Y. L. Nair Charitable Hospital, Mumbai: 400008, India; Shahroud University of Medical Sciences; University of Kent Canterbury; Hope Generation Foundation; Taylor’s University; Istanbul Medipol University; Suez Canal University; Università degli studi di Torino = University of Turin (UNITO); University of Bucharest (UniBuc); King Abdulaziz Medical City; Department of Surgery, Riyadh, Saudi Arabia; Ankara University School of Medicine Turkey; Kurukshetra University; University of Malaya = Universiti Malaya Kuala Lumpur, Malaisie (UM); Universitas Padjadjaran (UnPad); Jordan University of Science and Technology Irbid, Jordan (JUST); University of Zambia Lusaka (UNZA); Osaka University Osaka; الجامعة اللبنانية بيروت = Lebanese University Beirut = Université libanaise Beyrouth (LU / ULB); Al-Zahraa Hospital University Medical Center (ZHUMC); Kafkas University; The Chinese University of Hong Kong Hong Kong (CUHK); University of Illinois Springfield; Hôpital Américain de Paris; University of Massachusetts Medical School Worcester (UMASS); University of Massachusetts System (UMASS); McGovern Medical School Houston, Texas; The University of Texas Health Science Center at Houston (UTHealth); MD Anderson Cancer Center Houston; Lilavati Hospital and Research Centre; Institut médical Reprogynes; Fundació Puigvert Barcelona, Spain; Ege University Izmir; Assam University; Peking University Beijing; Istanbul University; University of Toledo; Universitas Airlangga (UNAIR); Università degli Studi di Roma "La Sapienza" = Sapienza University Rome (UNIROMA); CSIR-Central Drug Research Institute (CSIR-CDRI); Council of Scientific and Industrial Research India (CSIR); University of Ioannina; University of Garmian; University Hospital Centre Zagreb; Partenaires INRAE; Burjeel Hospital
نبذة مختصرة : International audience ; 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. 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. 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.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. ...
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