(Open access funding provided by Semmelweis University)
Szakterületek:
Metaanalízis
Urológia
Infertility affects one in every six couples in developed countries, and approximately
50% is of male origin. In 2021, sperm DNA fragmentation (SDF) testing became an evidence-based
test for fertility evaluations depicting fertility more clearly than standard semen
parameters. Therefore, we aimed to summarize the potential prognostic factors of a
higher SDF.We conducted a systematic search in three medical databases and included
studies investigating any risk factors for SDF values. We calculated mean differences
(MD) in SDF with 95% confidence interval (CI) for exposed and non-exposed individuals.We
included 190 studies in our analysis. In the group of associated health conditions,
varicocele (MD = 13.62%, CI: 9.39-17.84) and impaired glucose tolerance (MD = 13.75%,
CI: 6.99-20.51) had the most significant increase in SDF. Among malignancies, testicular
tumors had the highest impact, with a maximum of MD = 11.3% (CI: 7.84-14.76). Among
infections, the overall effects of both Chlamydia and HPV were negligible. Of lifestyle
factors, smoking had the most disruptive effect on SDF - an increase of 9.19% (CI:
4.33-14.06). Different periods of sexual abstinence did not show significant variations
in SDF values. Age seemed to have a more drastic effect on SDF from age 50 onwards,
with a mean difference of 12.58% (CI: 7.31-17.86). Pollution also had a detrimental
effect - 9.68% (CI: 6.85-12.52).Of the above risk factors, varicocele, impaired glucose
tolerance, testicular tumors, smoking, pollution, and paternal age of over 50 were
associated with the highest SDF.CRD42021282533.
