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3. Global Practice Patterns in the Evaluation of Non-Obstructive Azoospermia: Results of a World-Wide Survey and Expert Recommendations

Author

Shah, Rupin, primary, Rambhatla, Amarnath, additional, Atmoko, Widi, additional, Martinez, Marlon, additional, Ziouziou, Imad, additional, Kothari, Priyank, additional, Tadros, Nicholas, additional, Phuoc, Nguyen Ho Vinh, additional, Kavoussi, Parviz, additional, Harraz, Ahmed, additional, Salvio, Gianmaria, additional, Gul, Murat, additional, Hamoda, Taha, additional, Toprak, Tuncay, additional, Birowo, Ponco, additional, Ko, Edmund, additional, Arafa, Mohamed, additional, Ghayda, Ramy Abou, additional, Karthikeyan, Vilvapathy Senguttuvan, additional, Saleh, Ramadan, additional, Russo, Giorgio Ivan, additional, Pinggera, Germar-Michael, additional, Chung, Eric, additional, Savira, Missy, additional, Colpi, Giovanni M., additional, Zohdy, Wael, additional, Pescatori, Edoardo, additional, Park, Hyun Jun, additional, Fukuhara, Shinichiro, additional, Tsujimura, Akira, additional, Rojas-Cruz, Cesar, additional, Marino, Angelo, additional, Mak, Siu King, additional, Amar, Edouard, additional, Ibrahim, Wael, additional, Sindhwani, Puneet, additional, Alhathal, Naif, additional, Busetto, Gian Maria, additional, Hashimi, Manaf Al, additional, El-Sakka, Ahmed, additional, Ramazan, Asci, additional, Dimitriadis, Fotios, additional, Timpano, Massimiliano, additional, Jezek, Davor, additional, Altay, Baris, additional, Zylbersztejn, Daniel Suslik, additional, Wong, Michael YC, additional, Moon, Du Geon, additional, Wyns, Christine, additional, Gamidov, Safar, additional, Akhavizadegan, Hamed, additional, Franceschelli, Alessandro, additional, Aydos, Kaan, additional, Quang, Vinh Nguyen, additional, Ashour, Shedeed, additional, Dayel, Adel Al, additional, Al-Marhoon, Mohamed S., additional, Micic, Sava, additional, Binsaleh, Saleh, additional, Hussein, Alayman, additional, Elbardisi, Haitham, additional, Mostafa, Taymour, additional, Taha, Emad, additional, Ramsay, Jonathan, additional, Zachariou, Athanasios, additional, Abdelrahman, Islam Fathy Soliman, additional, Rajmil, Osvaldo, additional, Kalkanli, Arif, additional, Molina, Juan Manuel Corral, additional, Bocu, Kadir, additional, Duarsa, Gede Wirya Kusuma, additional, Ceker, Gokhan, additional, Serefoglu, Ege Can, additional, Bahar, Fahmi, additional, Gherabi, Nazim, additional, Kuroda, Shinnosuke, additional, Bouzouita, Abderrazak, additional, Gudeloglu, Ahmet, additional, Ceyhan, Erman, additional, Hasan, Mohamed Saeed Mohamed, additional, Musa, Muhammad Ujudud, additional, Motawi, Ahmad, additional, Chak-Lam, Cho, additional, Taniguchi, Hisanori, additional, Ho, Christopher Chee Kong, additional, Vazquez, Jesus Fernando Solorzano, additional, Mutambirwa, Shingai, additional, Gungor, Nur Dokuzeylul, additional, Bendayan, Marion, additional, Giulioni, Carlo, additional, Baser, Aykut, additional, Falcone, Marco, additional, Boeri, Luca, additional, Blecher, Gideon, additional, Kheradmand, Alireza, additional, Sethupathy, Tamilselvi, additional, Adriansjah, Ricky, additional, Narimani, Nima, additional, Konstantinidis, Charalampos, additional, Nguyen, Tuan Thanh, additional, Japari, Andrian, additional, Dolati, Parisa, additional, Singh, Keerti, additional, Ozer, Cevahir, additional, Sarikaya, Selcuk, additional, Sheibak, Nadia, additional, Bosco, Ndagijimana Jean, additional, Özkent, Mehmet Serkan, additional, Le, Sang Thanh, additional, Sokolakis, Ioannis, additional, Katz, Darren, additional, Smith, Ryan, additional, Truong, Manh Nguyen, additional, Le, Tan V., additional, Huang, Zhongwei, additional, Deger, Muslim Dogan, additional, Arslan, Umut, additional, Calik, Gokhan, additional, Franco, Giorgio, additional, Rashed, Ayman, additional, Kahraman, Oguzhan, additional, Andreadakis, Sotiris, additional, Putra, Rosadi, additional, Balercia, Giancarlo, additional, Khalafalla, Kareim, additional, Cannarella, Rossella, additional, Tuấn, Anh Đặng, additional, Meliegy, Amr El, additional, Zilaitiene, Birute, additional, Ramirez, Marlene Lizbeth Zamora, additional, Giacone, Filippo, additional, Calogero, Aldo E., additional, Makarounis, Konstantinos, additional, Jindal, Sunil, additional, Hoai, Bac Nguyen, additional, Banthia, Ravi, additional, Peña, Marcelo Rodriguez, additional, Moorthy, Dharani, additional, Adamyan, Aram, additional, Kulaksiz, Deniz, additional, Kandil, Hussein, additional, Sofikitis, Nikolaos, additional, Salzano, Ciro, additional, Jungwirth, Andreas, additional, Banka, Surendra Reddy, additional, Mierzwa, Tiago Cesar, additional, Turunç, Tahsin, additional, Jain, Divyanu, additional, Avoyan, Armen, additional, Salacone, Pietro, additional, Kadıoğlu, Ateş, additional, Gupta, Chirag, additional, Lin, Haocheng, additional, Shamohammadi, Iman, additional, Mogharabian, Nasser, additional, Barrett, Trenton, additional, Danacıoğlu, Yavuz Onur, additional, Crafa, Andrea, additional, Daoud, Salima, additional, Malhotra, Vineet, additional, Almardawi, Abdulmalik, additional, Selim, Osama Mohamed, additional, Moussa, Mohamad, additional, Haghdani, Saeid, additional, Duran, Mesut Berkan, additional, Kunz, Yannic, additional, Preto, Mirko, additional, Eugeni, Elena, additional, Nguyen, Thang, additional, Elshahid, Ahmed Rashad, additional, Suyono, Seso Sulijaya, additional, Parikesit, Dyandra, additional, Nada, Essam, additional, Orozco, Eduardo Gutiérrez, additional, Boitrelle, Florence, additional, Trang, Nguyen Thi Minh, additional, Jamali, Mounir, additional, Nair, Raju, additional, Ruzaev, Mikhail, additional, Gadda, Franco, additional, Thomas, Charalampos, additional, Ferreira, Raphael Henrique, additional, Gul, Umit, additional, Maruccia, Serena, additional, Kanbur, Ajay, additional, Kinzikeeva, Ella, additional, Abumelha, Saad, additional, Quang, Nguyen, additional, Kosgi, Raghavender, additional, Gokalp, Fatih, additional, Soebadi, Mohammad Ayodhia, additional, Paul, Gustavo Marquesine, additional, Sajadi, Hesamoddin, additional, Gupte, Deepak, additional, Ambar, Rafael F., additional, Sogutdelen, Emrullah, additional, Singla, Karun, additional, Basurkano, Ari, additional, Kim, Shannon Hee Kyung, additional, Gilani, Mohammad Ali Sadighi, additional, Nagao, Koichi, additional, Brodjonegoro, Sakti Ronggowardhana, additional, Rezano, Andri, additional, Elkhouly, Mohamed, additional, Mazzilli, Rossella, additional, Farsi, Hasan M. A., additional, Ba, Hung Nguyen, additional, Alali, Hamed, additional, Kafetzis, Dimitrios, additional, Long, Tran Quang Tien, additional, Alsaid, Sami, additional, Cuong, Hoang Bao Ngoc, additional, Oleksandr, Knigavko, additional, Mustafa, Akhmad, additional, Acosta, Herik, additional, Pai, Hrishikesh, additional, Şahin, Bahadır, additional, Arianto, Eko, additional, Teo, Colin, additional, Jayaprakash, Sanjay Prakash, additional, Rachman, Rinaldo Indra, additional, Yenice, Mustafa Gurkan, additional, Sefrioui, Omar, additional, Paghdar, Smit, additional, Priyadarshi, Shivam, additional, Tanic, Marko, additional, Alfatlawy, Noor Kareem, additional, Rizaldi, Fikri, additional, Vishwakarma, Ranjit B., additional, Kanakis, George, additional, Cherian, Dinesh Thomas, additional, Lee, Joe, additional, Galstyan, Raisa, additional, Keskin, Hakan, additional, Wurzacher, Jana, additional, Seno, Doddy Hami, additional, Noegroho, Bambang S., additional, Margiana, Ria, additional, Javed, Qaisar, additional, Castiglioni, Fabrizio, additional, Tanwar, Raman, additional, Puigvert, Ana, additional, Kaya, Coşkun, additional, Purnomo, Medianto, additional, Yazbeck, Chadi, additional, Amir, Azwar, additional, Borges, Edson, additional, Bellavia, Marina, additional, Deswanto, Isaac Ardianson, additional, V, Vinod K, additional, Liguori, Giovanni, additional, Minh, Dang Hoang, additional, Siddiqi, Kashif, additional, Colombo, Fulvio, additional, Zini, Armand, additional, Patel, Niket, additional, Çayan, Selahittin, additional, Al-Kawaz, Ula, additional, Ragab, Maged, additional, Hebrard, Guadalupe Hernández, additional, Hoffmann, Ivan, additional, Efesoy, Ozan, additional, Saylam, Barış, additional, and Agarwal, Ashok, additional

Published
2024
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7. Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: A global survey, current guidelines, and expert recommendations

Author

Farkouh, Ala’a, Agarwal, Ashok, Hamoda, Taha Abo-Almagd Abdel-Meguid, Kavoussi, Parviz, Saleh, Ramadan, Zini, Armand, Arafa, Mohamed, Harraz, Ahmed M., Gul, Murat, Karthikeyan, Vilvapathy Senguttuvan, Durairajanayagam, Damayanthi, Rambhatla, Amarnath, Boitrelle, Florence, Chung, Eric, Birowo, Ponco, Toprak, Tuncay, Ghayda, Ramy Abou, Cannarella, Rossella, Phuoc, Nguyen Ho Vinh, Dimitriadis, Fotios, Russo, Giorgio I., Sokolakis, Ioannis, Mostafa, Taymour, Makarounis, Konstantinos, Ziouziou, Imad, Kuroda, Shinnosuke, Bendayan, Marion, Kaiyal, Raneen Sawaid, Japari, Andrian, Simopoulou, Mara, Rocco, Lucia, Garrido, Nicolas, Gherabi, Nazim, Bocu, Kadir, Kahraman, Oguzhan, Le, Tan V., Wyns, Christine, Tremellen, Kelton, Sarikaya, Selcuk, Lewis, Sheena, Evenson, Donald P., Ko, Edmund, Calogero, Aldo E., Bahar, Fahmi, Martinez, Marlon, Crafa, Andrea, Nguyen, Quang, Ambar, Rafael F., Colpi, Giovanni, Bakircioglu, Mustafa Emre, Henkel, Ralf, Kandil, Hussein, Serefoglu, Ege Can, Alarbid, Abdullah, Tsujimura, Akira, Kheradmand, Alireza, Anagnostopoulou, Christina, Marino, Angelo, Adamyan, Aram, Zilaitiene, Birute, Ozer, Cevahir, Pescatori, Edoardo, Vogiatzi, Paraskevi, Busetto, Gian Maria, Balercia, Giancarlo, Elbardisi, Haitham, Akhavizadegan, Hamed, Sajadi, Hesamoddin, Taniguchi, Hisanori, Park, Hyun Jun, Rosas, Israel Maldonado, Al-Marhoon, Mohamed, Gilani, Mohammad Ali Sadighi, Alhathal, Naif, Pinggera, Germar-Michael, Kothari, Priyank, Mogharabian, Nasser, Micic, Sava, Homa, Sheryl T., Darbandi, Sara, Long, Tran Quang Tien, Zohdy, Wael, Atmoko, Widi, Sabbaghian, Marjan, Ibrahim, Wael, Smith, Ryan P., Ho, Christopher Chee Kong, Rosette, Jean de la, El-Sakka, Ahmed I., Preto, Mirko, Zenoaga-Barbăroșie, Cătălina, Abumelha, Saad Mohammed, Baser, Aykut, Aydos, Kaan, Ramirez-Dominguez, Liliana, Kumar, Vijay, Ong, Teng Aik, Mierzwa, Tiago Cesar, Adriansjah, Ricky, Banihani, Saleem A., Bowa, Kasonde, Fukuhara, Shinichiro, Peña, Marcelo Rodriguez, Moussa, Mohamad, Ari, Umut Çağın, Cho, Chak-Lam, Tadros, Nicholas N., Ugur, Muhammet Rasit, Amar, Edouard, Falcone, Marco, Santer, Frederic Romain, Kalkanli, Arif, Karna, Keshab Kumar, Khalafalla, Kareim, Vishwakarma, Ranjit B., Finocchi, Federica, Giulioni, Carlo, Ceyhan, Erman, Çeker, Gökhan, Yazbeck, Chadi, Rajmil, Osvaldo, Yilmaz, Mehmet, Altay, Baris, Barrett, Trenton L., Ngoo, Kay Seong, Roychoudhury, Shubhadeep, Salvio, Gianmaria, Lin, Haocheng, Kadioglu, Ates, Timpano, Massimiliano, Avidor-Reiss, Tomer, Hakim, Lukman, Sindhwani, Puneet, Franco, Giorgio, Singh, Rajender, Giacone, Filippo, Ruzaev, Mikhail, Kosgi, Raghavender, Sofikitis, Nikolaos, Palani, Ayad, Calik, Gokhan, Kulaksız, Deniz, Jezek, Davor, Al Hashmi, Manaf, Drakopoulos, Panagiotis, Omran, Huda, Leonardi, Sofia, Celik-Ozenci, Ciler, Güngör, Nur Dokuzeylül, Ramsay, Jonathan, Amano, Toshiyasu, Sogutdelen, Emrullah, Duarsa, Gede Wirya Kusuma, Chiba, Koji, Jindal, Sunil, Savira, Missy, Boeri, Luca, Borges, Edson, Gupte, Deepak, Gokalp, Fatih, Hebrard, Guadalupe Hernández, Minhas, Suks, Shah, Rupin, Farkouh, Ala’a, Agarwal, Ashok, Hamoda, Taha Abo-Almagd Abdel-Meguid, Kavoussi, Parviz, Saleh, Ramadan, Zini, Armand, Arafa, Mohamed, Harraz, Ahmed M., Gul, Murat, Karthikeyan, Vilvapathy Senguttuvan, Durairajanayagam, Damayanthi, Rambhatla, Amarnath, Boitrelle, Florence, Chung, Eric, Birowo, Ponco, Toprak, Tuncay, Ghayda, Ramy Abou, Cannarella, Rossella, Phuoc, Nguyen Ho Vinh, Dimitriadis, Fotios, Russo, Giorgio I., Sokolakis, Ioannis, Mostafa, Taymour, Makarounis, Konstantinos, Ziouziou, Imad, Kuroda, Shinnosuke, Bendayan, Marion, Kaiyal, Raneen Sawaid, Japari, Andrian, Simopoulou, Mara, Rocco, Lucia, Garrido, Nicolas, Gherabi, Nazim, Bocu, Kadir, Kahraman, Oguzhan, Le, Tan V., Wyns, Christine, Tremellen, Kelton, Sarikaya, Selcuk, Lewis, Sheena, Evenson, Donald P., Ko, Edmund, Calogero, Aldo E., Bahar, Fahmi, Martinez, Marlon, Crafa, Andrea, Nguyen, Quang, Ambar, Rafael F., Colpi, Giovanni, Bakircioglu, Mustafa Emre, Henkel, Ralf, Kandil, Hussein, Serefoglu, Ege Can, Alarbid, Abdullah, Tsujimura, Akira, Kheradmand, Alireza, Anagnostopoulou, Christina, Marino, Angelo, Adamyan, Aram, Zilaitiene, Birute, Ozer, Cevahir, Pescatori, Edoardo, Vogiatzi, Paraskevi, Busetto, Gian Maria, Balercia, Giancarlo, Elbardisi, Haitham, Akhavizadegan, Hamed, Sajadi, Hesamoddin, Taniguchi, Hisanori, Park, Hyun Jun, Rosas, Israel Maldonado, Al-Marhoon, Mohamed, Gilani, Mohammad Ali Sadighi, Alhathal, Naif, Pinggera, Germar-Michael, Kothari, Priyank, Mogharabian, Nasser, Micic, Sava, Homa, Sheryl T., Darbandi, Sara, Long, Tran Quang Tien, Zohdy, Wael, Atmoko, Widi, Sabbaghian, Marjan, Ibrahim, Wael, Smith, Ryan P., Ho, Christopher Chee Kong, Rosette, Jean de la, El-Sakka, Ahmed I., Preto, Mirko, Zenoaga-Barbăroșie, Cătălina, Abumelha, Saad Mohammed, Baser, Aykut, Aydos, Kaan, Ramirez-Dominguez, Liliana, Kumar, Vijay, Ong, Teng Aik, Mierzwa, Tiago Cesar, Adriansjah, Ricky, Banihani, Saleem A., Bowa, Kasonde, Fukuhara, Shinichiro, Peña, Marcelo Rodriguez, Moussa, Mohamad, Ari, Umut Çağın, Cho, Chak-Lam, Tadros, Nicholas N., Ugur, Muhammet Rasit, Amar, Edouard, Falcone, Marco, Santer, Frederic Romain, Kalkanli, Arif, Karna, Keshab Kumar, Khalafalla, Kareim, Vishwakarma, Ranjit B., Finocchi, Federica, Giulioni, Carlo, Ceyhan, Erman, Çeker, Gökhan, Yazbeck, Chadi, Rajmil, Osvaldo, Yilmaz, Mehmet, Altay, Baris, Barrett, Trenton L., Ngoo, Kay Seong, Roychoudhury, Shubhadeep, Salvio, Gianmaria, Lin, Haocheng, Kadioglu, Ates, Timpano, Massimiliano, Avidor-Reiss, Tomer, Hakim, Lukman, Sindhwani, Puneet, Franco, Giorgio, Singh, Rajender, Giacone, Filippo, Ruzaev, Mikhail, Kosgi, Raghavender, Sofikitis, Nikolaos, Palani, Ayad, Calik, Gokhan, Kulaksız, Deniz, Jezek, Davor, Al Hashmi, Manaf, Drakopoulos, Panagiotis, Omran, Huda, Leonardi, Sofia, Celik-Ozenci, Ciler, Güngör, Nur Dokuzeylül, Ramsay, Jonathan, Amano, Toshiyasu, Sogutdelen, Emrullah, Duarsa, Gede Wirya Kusuma, Chiba, Koji, Jindal, Sunil, Savira, Missy, Boeri, Luca, Borges, Edson, Gupte, Deepak, Gokalp, Fatih, Hebrard, Guadalupe Hernández, Minhas, Suks, and Shah, Rupin

Abstract

Purpose Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive 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. Materials and Methods An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, 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 formulated and adapted using the Delphi method. Results 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 unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, 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. Conclusions This paper presents the results of a large global survey on the management of infertile men with elevat

Published
2023

8. Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Author

Agarwal, Ashok, Farkouh, Ala’a, Saleh, Ramadan, Abdel-Meguid Hamoda, Taha Abo-Almagd, Harraz, Ahmed M., Kavoussi, Parviz, Arafa, Mohamed, Salvio, Gianmaria, Rambhatla, Amarnath, Toprak, Tuncay, Gül, Murat, Phuoc, Nguyen Ho Vinh, Boitrelle, Florence, Birowo, Ponco, Ghayda, Ramy Abou, Cannarella, Rossella, Kuroda, Shinnosuke, Durairajanayagam, Damayanthi, Zini, Armand, Wyns, Christine, Sarikaya, Selcuk, Tremellen, Kelton, Mostafa, Taymour, Sokolakis, Ioannis, Evenson, Donald P., Henkel, Ralf, Zohdy, Wael, Chung, Eric, Ziouziou, Imad, Falcone, Marco, Russo, Giorgio I., Al-Hashimi, Manaf, Calogero, Aldo E., Ko, Edmund, Colpi, Giovanni, Lewis, Sheena, Serefoglu, Ege Can, Bahar, Fahmi, Martinez, Marlon, Nguyen, Quang, Ambar, Rafael F., Bakircioglu, Mustafa Emre, Kandil, Hussein, Mogharabian, Nasser, Sabbaghian, Marjan, Taniguchi, Hisanori, Tsujimura, Akira, Sajadi, Hesamoddin, Ibrahim, Wael, Atmoko, Widi, Vogiatzi, Paraskevi, Gunes, Sezgin, Gilani, Mohammad Ali Sadighi, Roychoudhury, Shubhadeep, Güngör, Nur Dokuzeylül, Hakim, Lukman, Adriansjah, Ricky, Kothari, Priyank, Jindal, Sunil, Amar, Edouard, Park, Hyun Jun, Long, Tran Quang Tien, Homa, Sheryl T., Karthikeyan, Vilvapathy Senguttuvan, Zilaitiene, Birute, Rosas, Israel Maldonado, Marino, Angelo, Pescatori, Edoardo, Ozer, Cevahir, Akhavizadegan, Hamed, Garrido, Nicolas, Busetto, Gian Maria, Adamyan, Aram, Al-Marhoon, Mohamed, Elbardisi, Haitham, Dolati, Parisa, Darbandi, Mahsa, Darbandi, Sara, Balercia, Giancarlo, Pinggera, Germar-Michael, Micic, Sava, Ho, Christopher Chee Kong, Moussa, Mohamad, Preto, Mirko, Zenoaga-Barbăroşie, Cătălina, Smith, Ryan P., Kosgi, Raghavender, Rosette, Jean de la, El-Sakka, Ahmed I., Abumelha, Saad Mohammed, Mierzwa, Tiago Cesar, Ong, Teng Aik, Banihani, Saleem A., Bowa, Kasonde, Fukuhara, Shinichiro, Boeri, Luca, Danacıoğlu, Yavuz Onur, Gokalp, Fatih, Selim, Osama Mohamed, Cho, Chak-Lam, Tadros, Nicholas N., Ugur, Muhammet Rasit, Ozkent, Mehmet Serkan, Chiu, Peter, Kalkanli, Arif, Khalafalla, Kareim, Vishwakarma, Ranjit B., Finocchi, Federica, Andreadakis, Sotiris, Giulioni, Carlo, Çeker, Gökhan, Ceyhan, Erman, Malhotra, Vineet, Yilmaz, Mehmet, Timpano, Massimiliano, Barrett, Trenton L., Kim, Shannon Hee Kyung, Ahn, Sun-Tae, Giacone, Filippo, Palani, Ayad, Duarsa, Gede Wirya Kusuma, Kadioglu, Ates, Gadda, Franco, Zylbersztejn, Daniel Suslik, Aydos, Kaan, Kulaksız, Deniz, Gupte, Deepak, Calik, Gokhan, Karna, Keshab Kumar, Drakopoulos, Panagiotis, Baser, Aykut, Kumar, Vijay, Molina, Juan Manuel Corral, Rajmil, Osvaldo, Ferreira, Raphael H., Leonardi, Sofia, Avoyan, Armen, Sogutdelen, Emrullah, Franco, Giorgio, Ramsay, Jonathan, Ramirez, Liliana, Shah, Rupin, Agarwal, Ashok, Farkouh, Ala’a, Saleh, Ramadan, Abdel-Meguid Hamoda, Taha Abo-Almagd, Harraz, Ahmed M., Kavoussi, Parviz, Arafa, Mohamed, Salvio, Gianmaria, Rambhatla, Amarnath, Toprak, Tuncay, Gül, Murat, Phuoc, Nguyen Ho Vinh, Boitrelle, Florence, Birowo, Ponco, Ghayda, Ramy Abou, Cannarella, Rossella, Kuroda, Shinnosuke, Durairajanayagam, Damayanthi, Zini, Armand, Wyns, Christine, Sarikaya, Selcuk, Tremellen, Kelton, Mostafa, Taymour, Sokolakis, Ioannis, Evenson, Donald P., Henkel, Ralf, Zohdy, Wael, Chung, Eric, Ziouziou, Imad, Falcone, Marco, Russo, Giorgio I., Al-Hashimi, Manaf, Calogero, Aldo E., Ko, Edmund, Colpi, Giovanni, Lewis, Sheena, Serefoglu, Ege Can, Bahar, Fahmi, Martinez, Marlon, Nguyen, Quang, Ambar, Rafael F., Bakircioglu, Mustafa Emre, Kandil, Hussein, Mogharabian, Nasser, Sabbaghian, Marjan, Taniguchi, Hisanori, Tsujimura, Akira, Sajadi, Hesamoddin, Ibrahim, Wael, Atmoko, Widi, Vogiatzi, Paraskevi, Gunes, Sezgin, Gilani, Mohammad Ali Sadighi, Roychoudhury, Shubhadeep, Güngör, Nur Dokuzeylül, Hakim, Lukman, Adriansjah, Ricky, Kothari, Priyank, Jindal, Sunil, Amar, Edouard, Park, Hyun Jun, Long, Tran Quang Tien, Homa, Sheryl T., Karthikeyan, Vilvapathy Senguttuvan, Zilaitiene, Birute, Rosas, Israel Maldonado, Marino, Angelo, Pescatori, Edoardo, Ozer, Cevahir, Akhavizadegan, Hamed, Garrido, Nicolas, Busetto, Gian Maria, Adamyan, Aram, Al-Marhoon, Mohamed, Elbardisi, Haitham, Dolati, Parisa, Darbandi, Mahsa, Darbandi, Sara, Balercia, Giancarlo, Pinggera, Germar-Michael, Micic, Sava, Ho, Christopher Chee Kong, Moussa, Mohamad, Preto, Mirko, Zenoaga-Barbăroşie, Cătălina, Smith, Ryan P., Kosgi, Raghavender, Rosette, Jean de la, El-Sakka, Ahmed I., Abumelha, Saad Mohammed, Mierzwa, Tiago Cesar, Ong, Teng Aik, Banihani, Saleem A., Bowa, Kasonde, Fukuhara, Shinichiro, Boeri, Luca, Danacıoğlu, Yavuz Onur, Gokalp, Fatih, Selim, Osama Mohamed, Cho, Chak-Lam, Tadros, Nicholas N., Ugur, Muhammet Rasit, Ozkent, Mehmet Serkan, Chiu, Peter, Kalkanli, Arif, Khalafalla, Kareim, Vishwakarma, Ranjit B., Finocchi, Federica, Andreadakis, Sotiris, Giulioni, Carlo, Çeker, Gökhan, Ceyhan, Erman, Malhotra, Vineet, Yilmaz, Mehmet, Timpano, Massimiliano, Barrett, Trenton L., Kim, Shannon Hee Kyung, Ahn, Sun-Tae, Giacone, Filippo, Palani, Ayad, Duarsa, Gede Wirya Kusuma, Kadioglu, Ates, Gadda, Franco, Zylbersztejn, Daniel Suslik, Aydos, Kaan, Kulaksız, Deniz, Gupte, Deepak, Calik, Gokhan, Karna, Keshab Kumar, Drakopoulos, Panagiotis, Baser, Aykut, Kumar, Vijay, Molina, Juan Manuel Corral, Rajmil, Osvaldo, Ferreira, Raphael H., Leonardi, Sofia, Avoyan, Armen, Sogutdelen, Emrullah, Franco, Giorgio, Ramsay, Jonathan, Ramirez, Liliana, and Shah, Rupin

Abstract

Purpose: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. Materials and Methods: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. Results: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. Conclusions: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline

Published
2023

10. Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations

Author

Shah, Rupin, Agarwal, Ashok, Kavoussi, Parviz, Rambhatla, Amarnath, Saleh, Ramadan, Cannarella, Rossella, Harraz, Ahmed M., Boitrelle, Florence, Kuroda, Shinnosuke, Hamoda, Taha Abo-Almagd Abdel-Meguid, Zini, Armand, Ko, Edmund, Çalık, Gökhan, Toprak, Tuncay, Kandil, Hussein, Gül, Murat, Bakırcıoğlu, Mustafa Emre, Parekh, Neel, Russo, Giorgio Ivan, Tadros, Nicholas, Kadıoğlu, Ateş, Arafa, Mohamed, Chung, Eric, Rajmil, Osvaldo, Dimitriadis, Fotios, Malhotra, Vineet, Salvio, Gianmaria, Henkel, Ralf, Le, Tan V., Sogutdelen, Emrullah, Vij, Sarah, Alarbid, Abdullah, Güdeloğlu, Ahmet, Tsujimura, Akira, Calogero, Aldo E., El Meliegy, Amr, Crafa, Andrea, Kalkanlı, Arif, Baser, Aykut, Hazır, Berk, Giulioni, Carlo, Cho, Chak-Lam, Ho, Christopher C.K., Salzano, Ciro, Zylbersztejn, Daniel Suslik, Tien, Dung Mai Ba, Pescatori, Edoardo, Borges, Edson, Saïs-Hamza, Eminej, Huyghe, Eric, Ceyhan, Erman, Caroppo, Ettore, Castiglioni, Fabrizio, Bahar, Fahmi, Gökalp, Fatih, Lombardo, Francesco, Gadda, Franco, Duarsa, Gede Wirya Kusuma, Pinggera, Germar-Michael, Busetto, Gian Maria, Balercia, Giancarlo, Cito, Gianmartin, Blecher, Gideon, Franco, Giorgio, Liguori, Giovanni, Elbardisi, Haitham, Keskin, Hakan, Lin, Haocheng, Taniguchi, Hisanori, Park, Hyun Jun, Ziouziou, Imad, de la Rosette, Jean J. M. C. H., Hotaling, Jim, Ramsay, Jonathan, Molina, Juan Manuel Corral, Lo, Ka Lun, Böcü, Kadir, Khalafalla, Kareim, Bowa, Kasonde, Okada, Keisuke, Nagao, Koichi, Chiba, Koji, Hakim, Lukman, Makarounis, Konstantinos, Hehemann, Marah, Peña, Marcelo Rodriguez, Falcone, Marco, Bendayan, Marion, Martinez, Marlon, Timpano, Massimiliano, Altan, Mesut, Fode, Mikkel, Al-Marhoon, Mohamed S., Gilani, Mohammad Ali Sadighi, Soebadi, Mohammad Ayodhia, Gherabi, Nazim, Sofikitis, Nikolaos, Kahraman, Oğuzhan, Birowo, Ponco, Kothari, Priyank, Sindhwani, Puneet, Javed, Qaisar, Ambar, Rafael F., Kosgi, Raghavender, Ghayda, Ramy Abou, Adriansjah, Ricky, Condorelli, Rosita Angela, La Vignera, Sandro, Micic, Sava, Kim, Shannon Hee Kyung, Fukuhara, Shinichiro, Ahn, Sun Tae, Mostafa, Taymour, Ong, Teng Aik, Takeshima, Teppei, Amano, Toshiyasu, Barrett, Trenton, Arslan, Umut, Karthikeyan, Vilvapathy Senguttuvan, Atmoko, Widi, Yumura, Yasushi, Yuan, Yiming, Kato, Yuki, Jezek, Davor, Cheng, Bryan Kwun-Chung, Hatzichristodoulou, Georgios, Dy, Jun, Castañé, Eduard Ruiz, El-Sakka, Ahmed I., Nguyen, Quang, Sarıkaya, Selçuk, Boeri, Luca, Tan, Ronny, Moussa, Mohamad A., El-Assmy, Ahmed, Alali, Hamed, Alhathal, Naif, Osman, Yasser, Perovic, Dragoljub, Sajadi, Hesamoddin, Akhavizadegan, Hamed, Vučinić, Miroslav, Kattan, Said, Kattan, Mohamed S., Mogharabian, Nasser, Phuoc, Nguyen Ho Vinh, Ngoo, Kay Seong, Alkandari, Mohammad H., Alsuhaibani, Shaheed, Sokolakis, Ioannis, Babaei, Mehdi, King, Mak Siu, Diemer, Thorsten, Gava, Marcelo M., Henrique, Raphael, Spinola e Silva, Rodrigo, Paul, Gustavo Marquesine, Mierzwa, Tiago Cesar, Glina, Sidney, Siddiqi, Kashif, Wu, Han, Wurzacher, Jana, Farkouh, Ala'a, Son, Hwancheol, Minhas, Suks, Lee, Joe, Magsanoc, Nikko, Capogrosso, Paolo, Albano, German Jose, Lewis, Sheena E.M., Jayasena, Channa N., Alvarez, Juan G., Teo, Colin, Smith, Ryan P., Chua, Jo Ben M., Jensen, Christian Fuglesang S., Parekattil, Sijo, Finelli, Renata, Durairajanayagam, Damayanthi, Karna, Keshab Kumar, Ahmed, Abdelkareem, Evenson, Don, Umemoto, Yukihiro, Puigvert, Ana, Çeker, Gökhan, Colpi, Giovanni M., Rolitsky, Sarah, Bouzouita, Abderrazak, Shokeir, Ahmed, Aşçı, Ahmet, Bouker, Amin, Adamyan, Aram, Avoyan, Armen E., Palani, Ayad, Aghamajidi, Azin, Eze, Balantine, Noegroho, Bambang Sasongko, Purnomo, Basuki, Erkan, Bircan Kolbaşı, Zilaitiene, Birute, Kulaksız, Deniz, Kafetzis, Dimitrios, Lee, Dong Sup, Stember, Doron, Evgeni, Evangelini, Alhajeri, Faisal, Finocchi, Federica, Colombo, Fulvio, Tsangaris, George, Sallam, Hassan N., Acosta, Herik, Rosas, Israel Maldonado, Kirkman-Brown, Jackson, Shin, Jae Il, Sonksen, Jens, Dong, Jie, Marmar, Joel, Moreno-Sepulveda, Jose, Seo, Ju Tae, Aydos, Kaan, Kesari, Kavindra Kumar, Trost, Landon, Jenkins, Lawrence, Rocco, Lucia, Darbandi, Mahsa, Simopoulou, Mara, Alves, Marco, Sabbaghian, Marjan, Tavalaee, Marziyeh, Razi, Mazdak, Duran, Mesut Berkan, Nago, Mitsuru, Elkhouly, Mohamed, Khalili, Mohamed, Nasr-Esfahani, Mohammad Hossein, Kamath, Mohan S., Uğur, Muhammet Raşit, Park, Nam Cheol, Cruz, Natalio, Garrido, Nicolas, Sodeifi, Niloofar, Al Khalidi, Noora, Shoshany, Ohad, Satyagraha, Paksi, Drakopoulos, Panagiotos, Vogiatzi, Paraskevi, Dolati, Parisa, Das, Partha, Chiu, Peter Ka-Fung, Tsioulou, Petroula A., Patel, Premal, Singh, Rajender, Kaiyal, Raneen Sawaid, Santos, Ferreira, Dada, Rima, Brodjonegoro, Sakti, Banihani, Saleem Ali, Schon, Samantha, Darbandi, Sara, Güneş, Sezgin, Homa, Sheryl, Mutambirwa, Shingai, Roychoudhury, Shubhadeep, Diaz, Sofia Ines Leonardi, Gopalakrishnan, Sreelatha, Krawetz, Stephen, Jindal, Sunil, Avidor-Reiss, Tomer, Lin, Tsung Yen, Kumar, Vijay, Ibrahim, Wael, Kerkeni, Walid, Woo, Wongi, Morimoto, Yoshiharu, Cheng, Yu-Sheng, Shah, Rupin, Agarwal, Ashok, Kavoussi, Parviz, Rambhatla, Amarnath, Saleh, Ramadan, Cannarella, Rossella, Harraz, Ahmed M., Boitrelle, Florence, Kuroda, Shinnosuke, Hamoda, Taha Abo-Almagd Abdel-Meguid, Zini, Armand, Ko, Edmund, Calik, Gokhan, Toprak, Tuncay, Kandil, Hussein, Gül, Murat, Bakırcıoğlu, Mustafa Emre, Parekh, Neel, Russo, Giorgio Ivan, Tadros, Nichola, Kadioglu, Ate, Arafa, Mohamed, Chung, Eric, Rajmil, Osvaldo, Dimitriadis, Fotio, Malhotra, Vineet, Salvio, Gianmaria, Henkel, Ralf, Le, Tan V., Sogutdelen, Emrullah, Vij, Sarah, Alarbid, Abdullah, Gudeloglu, Ahmet, Tsujimura, Akira, Calogero, Aldo E., Meliegy, Amr El, Crafa, Andrea, Kalkanli, Arif, Baser, Aykut, Hazir, Berk, Giulioni, Carlo, Cho, Chak-Lam, Ho, Christopher C. K., Salzano, Ciro, Zylbersztejn, Daniel Suslik, Tien, Dung Mai Ba, Pescatori, Edoardo, Borges, Edson, Serefoglu, Ege Can, Sas-Hamza, Emine, Huyghe, Eric, Ceyhan, Erman, Caroppo, Ettore, Castiglioni, Fabrizio, Bahar, Fahmi, Gokalp, Fatih, Lombardo, Francesco, Gadda, Franco, Duarsa, Gede Wirya Kusuma, Pinggera, Germar-Michael, Busetto, Gian Maria, Balercia, Giancarlo, Cito, Gianmartin, Blecher, Gideon, Franco, Giorgio, Liguori, Giovanni, Elbardisi, Haitham, Keskin, Hakan, Lin, Haocheng, Taniguchi, Hisanori, Park, Hyun Jun, Ziouziou, Imad, Rosette, Jean de la, Hotaling, Jim, Ramsay, Jonathan, Molina, Juan Manuel Corral, Lo, Ka Lun, Bocu, Kadir, Khalafalla, Kareim, Bowa, Kasonde, Okada, Keisuke, Nagao, Koichi, Chiba, Koji, Hakim, Lukman, Makarounis, Konstantino, Hehemann, Marah, Peña, Marcelo Rodriguez, Falcone, Marco, Bendayan, Marion, Martinez, Marlon, Timpano, Massimiliano, Altan, Mesut, Fode, Mikkel, Al-Marhoon, Mohamed S., Gilani, Mohammad Ali Sadighi, Soebadi, Mohammad Ayodhia, Gherabi, Nazim, Sofikitis, Nikolao, Kahraman, Oğuzhan, Birowo, Ponco, Kothari, Priyank, Sindhwani, Puneet, Javed, Qaisar, Ambar, Rafael F., Kosgi, Raghavender, Ghayda, Ramy Abou, Adriansjah, Ricky, Condorelli, Rosita Angela, Vignera, Sandro La, Micic, Sava, Kim, Shannon Hee Kyung, Fukuhara, Shinichiro, Ahn, Sun Tae, Mostafa, Taymour, Ong, Teng Aik, Takeshima, Teppei, Amano, Toshiyasu, Barrett, Trenton, Arslan, Umut, Karthikeyan, Vilvapathy Senguttuvan, Atmoko, Widi, Yumura, Yasushi, Yuan, Yiming, Kato, Yuki, Jezek, Davor, Cheng, Bryan Kwun-Chung, Hatzichristodoulou, Georgio, Dy, Jun, Castañé, Eduard Ruiz, El-Sakka, Ahmed I., Nguyen, Quang, Sarikaya, Selcuk, Boeri, Luca, Tan, Ronny, Moussa, Mohamad A., El-Assmy, Ahmed, Alali, Hamed, Alhathal, Naif, Osman, Yasser, Perovic, Dragoljub, Sajadi, Hesamoddin, Akhavizadegan, Hamed, Vučinić, Miroslav, Kattan, Said, Kattan, Mohamed S., Mogharabian, Nasser, Phuoc, Nguyen Ho Vinh, Ngoo, Kay Seong, Alkandari, Mohammad H., Alsuhaibani, Shaheed, Sokolakis, Ioanni, Babaei, Mehdi, King, Mak Siu, Diemer, Thorsten, Gava, Marcelo M., Henrique, Raphael, Silva, Rodrigo Spinola e, Paul, Gustavo Marquesine, Mierzwa, Tiago Cesar, Glina, Sidney, Siddiqi, Kashif, Wu, Han, Wurzacher, Jana, Farkouh, Ala’A, Son, Hwancheol, Minhas, Suk, Lee, Joe, Magsanoc, Nikko, Capogrosso, Paolo, Albano, German Jose, Lewis, Sheena E. M., Jayasena, Channa N., Alvarez, Juan G., Teo, Colin, Smith, Ryan P., Chua, Jo Ben M., Jensen, Christian Fuglesang S., Parekattil, Sijo, Finelli, Renata, Durairajanayagam, Damayanthi, Karna, Keshab Kumar, Ahmed, Abdelkareem, Evenson, Don, Umemoto, Yukihiro, Puigvert, Ana, Çeker, Gökhan, Forum, Giovanni M Colpi, Shah, R., Agarwal, A., Kavoussi, P., Rambhatla, A., Saleh, R., Cannarella, R., Harraz, A. M., Boitrelle, F., Kuroda, S., Hamoda, T. A. -A. A. -M., Zini, A., Ko, E., Calik, G., Toprak, T., Kandil, H., Gul, M., Bakircioglu, M. E., Parekh, N., Russo, G. I., Tadros, N., Kadioglu, A., Arafa, M., Chung, E., Rajmil, O., Dimitriadis, F., Malhotra, V., Salvio, G., Henkel, R., Le, T. V., Sogutdelen, E., Vij, S., Alarbid, A., Gudeloglu, A., Tsujimura, A., Calogero, A. E., El Meliegy, A., Crafa, A., Kalkanli, A., Baser, A., Hazir, B., Giulioni, C., Cho, C. -L., Ho, C. C. K., Salzano, C., Zylbersztejn, D. S., Tien, D. M. B., Pescatori, E., Borges, E., Serefoglu, E. C., Sais-Hamza, E., Huyghe, E., Ceyhan, E., Caroppo, E., Castiglioni, F., Bahar, F., Gokalp, F., Lombardo, F., Gadda, F., Duarsa, G. W. K., Pinggera, G. -M., Busetto, G. M., Balercia, G., Cito, G., Blecher, G., Franco, G., Liguori, G., Elbardisi, H., Keskin, H., Lin, H., Taniguchi, H., Park, H. J., Ziouziou, I., de la Rosette, J., Hotaling, J., Ramsay, J., Molina, J. M. C., Lo, K. L., Bocu, K., Khalafalla, K., Bowa, K., Okada, K., Nagao, K., Chiba, K., Hakim, L., Makarounis, K., Hehemann, M., Pena, M. R., Falcone, M., Bendayan, M., Martinez, M., Timpano, M., Altan, M., Fode, M., Al-Marhoon, M. S., Gilani, M. A. S., Soebadi, M. A., Gherabi, N., Sofikitis, N., Kahraman, O., Birowo, P., Kothari, P., Sindhwani, P., Javed, Q., Ambar, R. F., Kosgi, R., Ghayda, R. A., Adriansjah, R., Condorelli, R. A., La Vignera, S., Micic, S., Kim, S. H. K., Fukuhara, S., Ahn, S. T., Mostafa, T., Ong, T. A., Takeshima, T., Amano, T., Barrett, T., Arslan, U., Karthikeyan, V. S., Atmoko, W., Yumura, Y., Yuan, Y., Kato, Y., Jezek, D., Cheng, B. K. -C., Hatzichristodoulou, G., Dy, J., Castane, E. R., El-Sakka, A. I., Nguyen, Q., Sarikaya, S., Boeri, L., Tan, R., Moussa, M. A., El-Assmy, A., Alali, H., Alhathal, N., Osman, Y., Perovic, D., Sajadi, H., Akhavizadegan, H., Vucinic, M., Kattan, S., Kattan, M. S., Mogharabian, N., Phuoc, N. H. V., Ngoo, K. S., Alkandari, M. H., Alsuhaibani, S., Sokolakis, I., Babaei, M., King, M. S., Diemer, T., Gava, M. M., Henrique, R., Spinola e Silva, R., Paul, G. M., Mierzwa, T. C., Glina, S., Siddiqi, K., Wu, H., Wurzacher, J., Farkouh, A., Son, H., Minhas, S., Lee, J., Magsanoc, N., Capogrosso, P., Albano, G. J., Lewis, S. E. M., Jayasena, C. N., Alvarez, J. G., Teo, C., Smith, R. P., Chua, J. B. M., Jensen, C. F. S., Parekattil, S., Finelli, R., Durairajanayagam, D., Karna, K. K., Ahmed, A., Evenson, D., Umemoto, Y., Puigvert, A., Ceker, G., Colpi, G. M., Rolitsky, S., Bouzouita, A., Shokeir, A., Asci, A., Bouker, A., Adamyan, A., Avoyan, A. E., Palani, A., Aghamajidi, A., Eze, B., Noegroho, B. S., Purnomo, B., Erkan, B. K., Zilaitiene, B., Kulaksiz, D., Kafetzis, D., Lee, D. S., Stember, D., Evgeni, E., Alhajeri, F., Finocchi, F., Colombo, F., Tsangaris, G., Sallam, H. N., Acosta, H., Rosas, I. M., Kirkman-Brown, J., Shin, J. I., Sonksen, J., Dong, J., Marmar, J., Moreno-Sepulveda, J., Seo, J. T., Aydos, K., Kesari, K. K., Trost, L., Jenkins, L., Rocco, L., Darbandi, M., Simopoulou, M., Alves, M., Sabbaghian, M., Tavalaee, M., Razi, M., Duran, M. B., Nago, M., Elkhouly, M., Khalili, M., Nasr-Esfahani, M. H., Kamath, M. S., Ugur, M. R., Park, N. C., Cruz, N., Garrido, N., Sodeifi, N., Al Khalidi, N., Shoshany, O., Satyagraha, P., Drakopoulos, P., Vogiatzi, P., Dolati, P., Das, P., Chiu, P. K. -F., Tsioulou, P. A., Patel, P., Singh, R., Kaiyal, R. S., Santos, F., Dada, R., Brodjonegoro, S., Banihani, S. A., Schon, S., Darbandi, S., Gunes, S., Homa, S., Mutambirwa, S., Roychoudhury, S., Diaz, S. I. L., Gopalakrishnan, S., Krawetz, S., Jindal, S., Avidor-Reiss, T., Lin, T. Y., Kumar, V., Ibrahim, W., Kerkeni, W., Woo, W., Morimoto, Y., Cheng, Y. -S., and Tıp Fakültesi

Subjects
Aging, Consensus, Urology, INGUINAL VARICOCELECTOMY, Disease management, Male infertility, Survey, Varicocele, Consensu, Global Andrology Forum, Endocrinology & Metabolism, NONOBSTRUCTIVE AZOOSPERMIA, ASSISTED REPRODUCTIVE TECHNOLOGY, Male Infertility, Pharmacology (medical), Andrology, IMPAIRED SEMEN QUALITY, EUROPEAN ASSOCIATION, Science & Technology, UROLOGY GUIDELINES, Health Policy, Public Health, Environmental and Occupational Health, Disease Management, Urology & Nephrology, SUBCLINICAL VARICOCELE, Psychiatry and Mental health, Health Care Sciences & Services, MICROSURGICAL SUBINGUINAL VARICOCELECTOMY, Reproductive Medicine, SPERM MORPHOLOGY, UNTREATED VARICOCELE, Life Sciences & Biomedicine
Abstract

Purpose: Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. Materials and Methods: Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological As- sociation [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. Results: The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/ uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the re- sponses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identi- fied where no guidelines are available. Conclusions: This study is the largest global survey performed to date on the clinical management of varicocele for male in- fertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical prac- tice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.

Published
2022

19. A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility

Author

Agarwal, Ashok, primary, Finelli, Renata, additional, Selvam, Manesh Kumar Panner, additional, Leisegang, Kristian, additional, Majzoub, Ahmad, additional, Tadros, Nicholas, additional, Ko, Edmund, additional, Parekh, Neel, additional, Henkel, Ralf, additional, Durairajanayagam, Damayanthi, additional, Colpi, Giovanni M., additional, Cho, Chak-Lam, additional, Sallam, Hassan N., additional, Park, Hyun Jun, additional, Saleh, Ramadan, additional, Micic, Sava, additional, Ambar, Rafael F., additional, Zini, Armand, additional, Tremellen, Kelton, additional, Alvarez, Juan G., additional, Palani, Ayad, additional, Arafa, Mohamed, additional, Gava, Marcello M., additional, Jindal, Sunil, additional, Amar, Edouard, additional, Kopa, Zsolt, additional, Moein, Mohammad-Reza, additional, Busetto, Gian Maria, additional, Sengupta, Pallav, additional, Kavoussi, Parviz, additional, Maldonado, Israel, additional, Fikri, Jamal, additional, Borges, Edson, additional, Martinez, Marlon, additional, Bojovic, Djordje, additional, Rajmil, Osvaldo, additional, Aydos, Kaan, additional, Parekattil, Sijo, additional, Marmar, Joel L., additional, Sefrioui, Omar, additional, Jungwirth, Andreas, additional, Peña, Marcelo Gabriel Rodriguez, additional, Cordts, Emerson B., additional, Elbardisi, Haitham, additional, Mostafa, Taymour, additional, Sabbaghian, Marjan, additional, Sadighi Gilani, Mohammad Ali, additional, Morimoto, Yoshiharu, additional, Alves, Marco G., additional, Spasic, Aleksandra, additional, Kenic, Uros, additional, Ramsay, Jonathan, additional, Akande, Ebenezer Oluwole, additional, Oumeziane, Amina, additional, Dozortsev, Dmitri, additional, Chung, Eric, additional, Bell, Ernestine Gwet, additional, Allegra, Adolfo, additional, Tanos, Vasilios, additional, Fiadjoe, Moïse, additional, Gurgan, Timur, additional, Abou-Abdallah, Michel, additional, Al-Rumaih, Hazem, additional, Oborna, Ivana, additional, Arab, Hesham, additional, Esteves, Sandro, additional, Amer, Medhat, additional, Kadioglu, Ates, additional, Yuzko, Oleksandr, additional, Korsak, Vladislav, additional, and Shah, Rupin, additional

Published
2021
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22. Boron-exposed male workers in Turkey

Author

Duydu, Yalcin, Basaran, Nursen, Yalcin, Can Özgür, Ustundag, Aylin, Aydin, Sevtap, Anlar, Hatice Gul, Bacanli, Merve, Aydos, Kaan, Atabekoglu, Cem Somer, Golka, Klaus, Ickstadt, Katja, Schwerdtle, Tanja (Prof.), Werner, Matthias, and Bolt, Hermann M.

Subjects
inorganic chemicals, ddc:570, Institut für Ernährungswissenschaft
Abstract

Boron-associated shifts in sex ratios at birth were suggested earlier and attributed to a decrease in Y- vs. X-bearing sperm cells. As the matter is pivotal in the discussion of reproductive toxicity of boron/borates, re-investigation in a highly borate-exposed population was required. In the present study, 304 male workers in Bandirma and Bigadic (Turkey) with different degrees of occupational and environmental exposure to boron were investigated. Boron was quantified in blood, urine and semen, and the persons were allocated to exposure groups along B blood levels. In the highest ("extreme") exposure group (n = 69), calculated mean daily boron exposures, semen boron and blood boron concentrations were 44.91 +/- 18.32 mg B/day, 1643.23 +/- 965.44 ng B/g semen and 553.83 +/- 149.52 ng B/g blood, respectively. Overall, an association between boron exposure and Y:X sperm ratios in semen was not statistically significant (p > 0.05). Also, the mean Y:X sperm ratios in semen samples of workers allocated to the different exposure groups were statistically not different in pairwise comparisons (p > 0.05). Additionally, a boron-associated shift in sex ratio at birth towards female offspring was not visible. In essence, the present results do not support an association between boron exposure and decreased Y:X sperm ratio in males, even under extreme boron exposure conditions.

Published
2019

24. Açıklanamayan erkek infertilitesi: gerçekten idiopatik mi? Azoospermik erkeklerde karşilaştirmali genomik hibridizasyon yöntemi ile DNA kopya sayisi varyasyonlari ve aday kromozomal lokuslarin belirlenmesi

Author

YARARBAS, Kanay, ILGIN RUHI, Hatice, AYDOS, Kaan, ELHAN, Atilla, and TUKUN, Ajlan

Subjects
male infertility,Azoospermia,Comparative Genomic Hybridization,CGH,Cryptic Chromosomal Changes,Copy number variations,CNV, Erkek İnfertilitesi,azoospermi,Karşılaştırmalı Genomik Hibridizasyon,Kriptik Kromozomal Değişiklikler,Kopya sayısı varyasyonları,CGH,CNV, Medicine, Tıp
Abstract

Background and Aim: Infertilityis one of the most common health problems affecting about one of five couples, and male factor contributes to aconsiderable proportion of this condition. This study aimed to detect DNA copynumber variations of azoospermic malesby high resolution comparative genomic hybridization and suggest candidatechromosomal loci associated with male infertility.Materials and Methods: By usingComparative Genomic Hybridization (CGH),we aimed to detect previously unidentified genetic etiologic factors amonginfertile males. Thus it may be possible to explain some idiopathic cases andprovide more accurate counselling to theaffected couples. This technique may also allow predicting de novo infertilityrelated loci.Results: A total of 90 patients wereanalyzed by comparative genomic hybridization. 49patients revealed at least one finding, whereas in 41 patients (46%) there wasno copy number variations detected by our technique. A total of 21 spermatogenesis– related genes was present within the CNV loci. Conclusion:The data obtained from this study showthat infertile males may carry some DNA copy number variations that may not be detected by conventionalmethods. With additional data, it may be possible to identify the etiologicsignificance of these variations., Amaç: İnfertilite, beş çiftten birinietkileyen, en yaygın sağlık sorunlarından biridir. Erkek faktörü, bu durumunönemli bir kısmını oluşturur. Bu çalışmanın amacı, azoospermik erkeklerdekarşilaştirmali genomik hibridizasyon yöntemi ile DNA kopya sayisivaryasyonlarının ve aday kromozomal lokuslarin belirlenmesidir.Gereç ve Yöntem: Bu çalışmadakarşılaştırmalı Genomik Hibridizasyon (CGH) yöntemiyle infertil erkeklerde dahaönce tanımlanamayan genetik etiyolojik faktörleri saptamayı amaçladık.Dolayısıyla bazı idiyopatik vakaları açıklamak ve etkilenen çiftlere daha doğrudanışmanlık sağlamak mümkün olabilir. Bu teknik aynı zamanda de novoinfertiliteye ilişkin loküslerin tahmin edilmesine izin verebilecektir.Bulgular: Toplam 90 hasta karşılaştırmalıgenomik hibridizasyon ile analiz edildi.49hasta en az bir bulgu ortaya çıkarırken, 41 hastada (% 46) tekniğimizlesaptanan kopya sayısı değişimi yoktu. CNV lokuslarında toplam 21 spermatogenezile ilgili gen mevcuttu.Sonuç:Çalışmadan elde edilen veriler, infertil erkeklerin geleneksel yöntemlerlesaptanamayacak bazı DNA kopya sayısı varyasyonları gösterebildiklerinigöstermektedir. Ek verilerle, bu varyasyonların etyolojik önemini saptamakmümkün olabilir.

Published
2018

25. Evaluation of the DNA damage in lymphocytes, sperm and buccal cells of workers under environmental and occupational boron exposure conditions

Author

BAŞARAN, Nurşen, primary, DUYDU, Yalçın, additional, ÜSTÜNDAĞ, Aylin, additional, TANER, Gökçe, additional, AYDIN, Sevtap, additional, ANLAR, Hatice Gül, additional, YALÇIN, Can Özgür, additional, BACANLI, Merve, additional, AYDOS, Kaan, additional, ATABEKOĞLU, Cem Somer, additional, GOLKA, Klaus, additional, ICKSTADT, Katja, additional, SCHWERDTLE, Tanja, additional, WERNER, Matthias, additional, MEYER, Sören, additional, and BOLT, Hermann M., additional

Published
2019
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28. ÜREME ENDOKRİNOLOJİSİ TEKNİKLERİ VE CERRAHİSİ

Author

BOZKURT, NURAY, Çöğendez, Ebru, Garipoğlu Dalgın, Ece, Dansuk, Ramazan, Demirel, Cem, Devranoğlu, Belgin, ZEYNELOĞLU, HULUSİ BÜLENT, Mülayim, Barış, Var, Turgut, FİDAN, ULAŞ, MÜMÜŞOĞLU, SEZCAN, Yılmaz, Müşerref Banu, OKYAY, RECEP EMRE, Orhon, Esat, ÖNALAN, GÖĞŞEN MEHMET, Özcan, Pınar, ÖZELÇİ, RUNA, Yüksel Özgör, Bahar, Ünlübilgin, Eylem, Kemal, Özgür, ÖZKAVUKCU, İSKENDER SİNAN, Özkaya, Enis, ÖZMEN, BATUHAN, Özon, Hakan, PABUÇCU, RECAİ, PABUÇCU, EMRE GÖKSAN, Ruso, Halil, Seçilmiş, Özlem, SELAM, FÜSUN BELGİN, Sertyel, Semra, SEYMEN, CEMİLE MERVE, Sözen, Eran O, ŞAHİN, ÇAĞDAŞ, Şanverdi, İlhan, ŞENTÜRK, MEHMET LEVENT, ŞEVKET, OSMAN, Yılmaz, Nafiye, ŞÜKÜR, YAVUZ EMRE, GÜNALP, GALİP SERDAR, TAŞDEMİR, NİCEL, TAVMERGEN GÖKER, EGE NAZAN, TAVMERGEN, EROL, MORALOĞLU TEKİN, ÖZLEM, TERZİ, HASAN, Tepe, Neslihan, TORUN, DENİZ, Turan, Volkan, UĞUR, METE GÜROL, Uğurlucan, Funda Güngör, ULUDAĞ, SEMİH ZEKİ, YARCI GÜRSOY, ASLI, HALİLOĞLU, AHMET HAKAN, Işık, Ayça, KAHYAOĞLU, İNCİ, ULUKUŞ, MURAT, Yerebasmaz, Neslihan, KAPLANOĞLU, İSKENDER, DOĞER, EMEK, KARABACAK, RECEP ONUR, KARAKOÇ SÖKMENSÜER, LALE, GÜMÜŞLÜ, SEYHAN, DİLBAZ, SERDAR, GÜLEKLİ, BÜLENT, Gökçe, Bağdegül, Karaman, Yücel, Yencılek, Raziye, DİLBAZ, BERNA, Akarsubaşı, İclal, AKDOĞAN, AYŞİN, Ertürk Aksakal, Sezin, ALTINKAYA, SÜNDÜZ ÖZLEM, ARAS TOSUN, DURU, AYDOS, KAAN, Bahçe, Muhterem, KİSELİ, MİNE, BAŞTU, ERCAN, Berkil, Hakan, Berkkanoğlu, Murat, CEYHAN, SEYİT TEMEL, CINCIK, Mehmet, Yaşa, Cenk, KORKMAZ, CEM, ÇAĞLAR, GAMZE SİNEM, Çayan, Selahattin, Ünsal, Evrim, ÇEBİ, SAİT ŞÜKRÜ, Kutlu, Tayfun, and ÇEPNİ, İSMAİL

Published
2017

30. Genetic Polymorphisms inPRM1,PRM2, andYBX2Genes are Associated with Male Factor Infertility

Author

Aydos, Oya Sena E., primary, Hekmatshoar, Yalda, additional, Altınok, Buket, additional, Özkan, Tülin, additional, Şakirağaoğlu, Onur, additional, Karadağ, Aynur, additional, Kaplan, Fuat, additional, Ilgaz, Seda, additional, Taşpınar, Mehmet, additional, Yükselen, Işıl, additional, Sunguroğlu, Asuman, additional, and Aydos, Kaan, additional

Published
2018
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31. Investigation of boron mediated reproductive and developmental effects in highly boron exposed population

Author

Duydu, Yalcin, primary, Basaran, Nursen, additional, Aydın, Sevtap, additional, Üstündag, Aylin, additional, Göktaş, Hatica Gül, additional, Yalcin, Can Özgür, additional, Bacanlı, Merve, additional, Sarigöl, Zehra, additional, Aydos, Kaan, additional, Atabekoglu, Cem Somer, additional, Schwerdtle, Tanja, additional, Golka, Klaus, additional, Ickstadt, Katja, additional, and Bolt, Hermann M., additional

Published
2017
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32. ADAMTS1 and ADAMTS5 metalloproteases produced by Sertoli cells: a potential diagnostic marker in azoospermia.

Author

Aydos, Oya Sena, Yukselten, Yunus, Ozkavukcu, Sinan, Sunguroglu, Asuman, and Aydos, Kaan

Subjects
SERTOLI cells, METALLOPROTEINASES, SPERMATOGENESIS, MALE infertility, CELL proliferation
Abstract

In this study, our aim was to detect protein levels of A Disintegrin and Metalloproteinase with Thrombospondin Motifs 1 and 5 (ADAMTS1 and ADAMTS5) proteases and to examine the effect of in vitro FSH supplementation on protease production in cultured Sertoli cells. The expression of metalloproteases, ADAMTS1, and ADAMTS5 were investigated in Sertoli cell cultures as well as in ejaculate of azoospermic men which then were compared with ejaculates of the fertile control group. A total of 15 azoospermic men, diagnosed as obstructive (OA, n = 5) and nonobstructive (NOA, n = 10) azoospermia were included in the study. ADAMTS1, ADAMTS5 and FSH receptors (FSHR) were found to be expressed 2.56, 2.10, and 2.66-fold less in Sertoli cells of NOA patients, than those of OA (p < 0.05). After rFSH was added onto Sertoli cell cultures of NOA patients, their expression did not increase significantly and did not reach to levels of control group. Evaluation of ejaculates revealed that the expression of ADAMTS1 and ADAMTS5 were insignificantly 1.03 and 1.1-fold higher in OA group (p > 0.05), respectively; however, in the NOA group, their expression were 1.70 and 1.96-fold lower, respectively, when compared with the fertile control group (p < 0.05) which was statistically significant. As a conclusion, the present study has revealed that insufficiency of ADAMTS1 and ADAMTS5 expression in Sertoli cells may have an important role in the etiology of male infertility. As expected due to low FSHR expression, rFSH response is impaired in NOA patients with relatively low ADAMTS expression response; therefore, such patients might hardly benefit from rFSH treatment. Further studies with larger cohorts may reveal ADAMTSs' potential use as a predictive marker for positive sperm retrieval in azoospermic patients who are scheduled to undergo testicular sperm extraction. Abbreviations: ADAM: A Disintegrin and Metalloproteinase; ADAMTS1 and ADAMTS5: A Disintegrin and Metalloproteinase with 10 Thrombospondin Motifs 1 and 5; ADAMTS: A Disintegrin and Metalloproteinase with Thrombospondin; ABP: androgen binding protein; CAMs: cell adhesion molecules; ECM: extracellular matrix; FSH: follicle stimulating hormone; FSHR: FSH receptors; HRP: horseradish peroxidase; MMP: matrix metalloproteinases; MP: metalloproteinases; NOA: nonobstructive azoospermia; OA: obstructive azoospermia; TIMP-1: tissue inhibitor of metalloproteinase-1 [ABSTRACT FROM AUTHOR]

Published
2019
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33. Is Boric Acid Toxic to Reproduction in Humans? Assessment of the Animal Reproductive Toxicity Data and Epidemiological Study Results

Author

Duydu, Yalçın, primary, Başaran, Nurşen, additional, Ustündağ, Aylin, additional, Aydın, Sevtap, additional, Undeğer, Ulkü, additional, Yavuz Ataman, Osman, additional, Aydos, Kaan, additional, Düker, Yalçın, additional, Ickstadt, Katja, additional, Schulze Waltrup, Brita, additional, Golka, Klaus, additional, and Maximilian Bolt, Hermann, additional

Published
2016
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38. Analysis of the correlation between sperm DNA integrity and conventional semen parameters in infertile men.

Author

Aydos, Oya Sena, Yükselten, Yunus, Kaplan, Fuat, Sunguroğlu, Asuman, and Aydos, Kaan

Subjects
AGAR, STATISTICAL correlation, DNA, ELECTROPHORESIS, INFERTILITY, MUTAGENICITY testing, SPERMATOZOA, SPERM motility, DATA analysis software, SEMEN analysis, SPERM count
Abstract

Copyright of Turkish Journal of Urology is the property of Turkish Association of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2015
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39. Assessment of DNA integrity (COMET assay) in sperm cells of boron-exposed workers

Author

Duydu, Yalçın, primary, Başaran, Nurşen, additional, Üstündağ, Aylin, additional, Aydın, Sevtap, additional, Ündeğer, Ülkü, additional, Ataman, Osman Yavuz, additional, Aydos, Kaan, additional, Düker, Yalçın, additional, Ickstadt, Katja, additional, Waltrup, Britta Schulze, additional, Golka, Klaus, additional, and Bolt, Hermann M., additional

Published
2011
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43. İnterfil erkeklerde antisperm antikorların kibrick testi ile gösterilmesi

Author

Aydos, Kaan and Diğer

Subjects
Agglutination tests, Urology, Infertility, Üroloji, Antispermatogenic agents, Men, Antibodies
Abstract

ÖZET 1987-1990 yılları arasında Ankara üniversitesi Tıp Fakültesi üroloji Anabilin Dalı'na infertilite yakınması ile başvuran 104 oligo ve normozoospermik olgu ile 16 fertil erkek, Kibrikck'in Makroskopik Jelatin Aglütinasyön testi kullanılarak immünolojik bakımdan değerlendirime tabi tutuldu. V Çalışmamızda kullanılan immünolojik testin, infertilite f izyopatolo jisinin araştırılmasında ve nedeni kesin olarak açık lanamayan infertilite olgularında tanıda güvenilir ve kolay uygu lanabilir bir yöntem olduğu görüldü. Bununla, infertil birey lerde antisperm antikor pozitifliği sıklığı * 22.1 bulunurken, fertil kontrol grubunda bu oran % 12.5 oldu, ancak aradaki fark istatistiksel olarak anlamlı değildi (p > 0.05). înfertil olgular arasında klinik ve laboratuvar olarak tespit edilen patolojik bulgular antikor varlığı bakımından değerlendirildiğinde ise, enfeksiyon ile anlamlı bir ilişki saptanmıştır. Nonselektif bir seçimde 30 olguluk seride yapılan seminal plazma antikor titrajında, % 10 olguda serum antikor titrajı yüksek olanların seminal plazmalarında da antisperm antikorlarının varlığı gösterildi. 57 66

Published
1991

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