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Numerous studies have demonstrated the detrimental effects of sperm DNA fragmentation (SDF) on reproductive outcomes, whether under natural or assisted conditions. The sperm DNA fragmentation (SDF) test has emerged as a valuable supplement in the evaluation of infertile men, and the rapid development of various SDF tests has enhanced the perception of its clinical utility. Consequently, the latest manual from the World Health Organization has determined that this test should be described as a specialized analysis (and thus applicable in many laboratories worldwide) rather than a research analysis. However, the normal reference ranges for these tests to evaluate male fertility potential remain controversial. This article addresses the pathophysiological aspects of sperm chromatin and the mechanisms underlying DNA fragmentation. The effects of this fragmentation on various reproductive outcomes are also reviewed. An analysis of the different available fragmentation tests is provided as well. Finally, we discuss preventive and therapeutic measures to reduce sperm DNA fragmentation and potential future research opportunities. [ABSTRACT FROM AUTHOR]

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