The sperm DNA fragmentation study group (SFRAG) guideline and its relevance for practicing gynecologists

This editorial highlights the key recommendations of the novel evidence-based Sperm DNA Fragmentation Guideline (SFRAG guideline) for gynecologists providing infertility care. Sperm DNA fragmentation is a biomarker of sperm’s chromatin quality. Elevated sperm DNA fragmentation rates contribute to couple’s infertility and negatively impact medically assisted reproduction outcomes. There are five main clinical scenarios in which gynecologists should consider sperm DNA fragmentation testing to guide their decision-making process. They include unexplained infertility, recurrent pregnancy loss, before (or after failed) medically assisted reproduction, and the presence of male infertility risk factors. The SFRAG guideline emphasizes the importance of corrective measures to decrease sperm DNA fragmentation rates and selection of the best medically assisted reproduction modality for the affected couples. The intended goal is to provide the foundation for standardizing care in this area while maintaining clinicians’ autonomy.