精子DNA碎片检测的临床专家共识

Clinical expert consensus on sperm DNA fragmentation detection

精子DNA碎片(sperm DNA fragmentation,SDF)在男性不育症中发生率较高。SDF常伴发少、弱精子症,也可发生于常规精液指标正常的不育症患者。其发生机制包括精子成熟障碍、凋亡异常和氧化应激过高等。由于很多文献报道其与自然妊娠和辅助生殖技术结局存在负相关,SDF检测已在男性不育症和辅助生殖技术中得到越来越广泛的应用。本专家共识复习和评估了SDF相关文献,对SDF的危险因素、检测方法、临床意义和处理等提出2项良好实践要点和9项推荐建议。本共识大部分推荐建议的证据和级别属于低或中等,表明仍需要进一步的研究证实临床应用SDF检测的价值。

The incidence of sperm DNA fragmentation(SDF)is higher in male infertile patient.SDF is often associated with oligozoospermia and asthenospermia,and can also occur in infertile patients with normal conventional semen parameters.The mechanisms include abnormal spermatozoa maturation process,abnormal apoptosis,and high oxidative stress.SDF detection has been widely used in male infertility and assisted reproductive technology(ART)due to the negative correlation between SDF and the outcome of natural pregnancy and ART reported in many literatures.This expert consensus reviewed and evaluated SDF related literature,and proposed 2 good practice points and 9 recommendations on risk factors,detection methods,clinical significance and treatment of SDF.The evidence and level of the most recommendations in this consensus are low or medium,indicating that further research is still needed to confirm the value of clinical application of SDF detection.