Sperm DNA integrity is important for fertility, however the incidence of high levels of DNA fragmentation (DNA fragmentation index (DFI) >30%) is not well described. In 2011, our clinics implemented guidelines for sperm DNA fragmentation (SDF) testing based on risk factors using the sperm chromatin structure assay (SCSA). The aim of this retrospective study is to characterise SDF and associated factors (age, semen parameters, smoking status and BMI) for sub-fertile males (n = 1082) and sperm donors (n = 234). The average DFI was 12.1 ± 9.8%. The distribution of men with low, moderate and high SDF (<15, 15–30 and >30%) was 74.8%, 19.4% and 5.8%, respectively. Men with high DFI were older (45 ± 9.5 vs 38 ± 6.7) and had lower percentage of motile sperm (38.8 ± 16.1% vs 55.3 ± 15.8%) than men with normal DFI. Over 17% of the men in the quartile with the highest age and lowest motility had a high DFI (>30%), compared to a high DFI rate of 2-4% for the other 3 quartiles. Repeat testing following lifestyle interventions was available for 29 couples where the men had high initial DFI (35 ± 9.5%). Of these men, 71.4% had a decrease of DFI into the moderate or low range. This study shows that SDF testing can be targeted based on age and sperm motility, thereby reducing unnecessary testing. Furthermore, we provide evidence that lifestyle modifications can reduce DNA fragmentation in men with high DFI.

精子DNA的完整性对于生育能力很重要，但是，高水平的DNA片段化（DNA片段化指数（DFI）> 30％）的发生率并没有得到很好的描述。在2011年，我们的诊所根据使用精子染色质结构测定（SCSA）的危险因素，实施了精子DNA片段化（SDF）测试的指南。这项回顾性研究的目的是表征亚生育力男性（n = 1082）和精子供体（n = 234）的SDF和相关因素（年龄，精液参数，吸烟状况和BMI）。平均DFI为12.1±9.8％。低，中和高SDF（<15、15-30和> 30％）的男性分布分别为74.8％，19.4％和5.8％。高DFI的男性比正常DFI的男性年龄更大（45±9.5 vs 38±6.7），活动精子百分比较低（38.8±16.1％vs 55.3±15.8％）。在四分位数中年龄最高，运动最低的男性中，超过17％的男性DFI高（> 30％），而其他三个四分位数中的2-4％的男性DFI率较高。在生活方式干预之后，对29对夫妇进行了重复测试，这些男人的初始DFI高（35±9.5％）。在这些男性中，有71.4％的DFI下降至中度或低度。这项研究表明，可以根据年龄和精子活力来确定SDF的检测目标，从而减少不必要的检测。此外，我们提供证据表明，改变生活方式可以减少DFI高的男性的DNA片段化。在这些男性中，有71.4％的DFI下降至中度或低度。这项研究表明，可以根据年龄和精子活力来确定SDF的检测目标，从而减少不必要的检测。此外，我们提供证据表明，改变生活方式可以减少DFI高的男性的DNA片段化。在这些男性中，有71.4％的DFI下降至中度或低度。这项研究表明，可以根据年龄和精子活力来确定SDF的检测目标，从而减少不必要的检测。此外，我们提供证据表明，改变生活方式可以减少DFI高的男性的DNA片段化。