Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations

Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study...

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Published in:World Journal of Men's Health
Main Author: Agarwal A.; Farkouh A.; Saleh R.; Hamoda T.A.-A.A.-M.; Salvio G.; Boitrelle F.; Harraz A.M.; Ghayda R.A.; Kavoussi P.; Gül M.; Toprak T.; Russo G.I.; Durairajanayagam D.; Rambhatla A.; Birowo P.; Cannarella R.; Phuoc N.H.V.; Zini A.; Arafa M.; Wyns C.; Tremellen K.; Sarıkaya S.; Lewis S.; Evenson D.P.; Ko E.; Calogero A.E.; Bahar F.; Martínez M.; Ambar R.F.; Colpi G.M.; Bakircioglu M.E.; Henkel R.; Kandil H.; Serefoglu E.C.; Alfakhri A.; Tsujimura A.; Kheradmand A.; Marino A.; Adamyan A.; Zilaitiene B.; Ozer C.; Pescatori E.; Vogiatzi P.; Busetto G.M.; Balercia G.; Elbardisi H.; Akhavizadegan H.; Sajadi H.; Taniguchi H.; Park H.J.; Rosas I.M.; Al-Marhoon M.; Gilani M.A.S.; Alhathal N.; Quang N.; Pinggera G.-M.; Kothari P.; Micic S.; Homa S.; Long T.Q.T.; Zohdy W.; Atmoko W.; Ibrahim W.; Sabbaghian M.; Abumelha S.M.; Chung E.; Ugur M.R.; Ozkent M.S.; Selim O.; Darbandi M.; Fukuhara S.; Jamali M.; de la Rosette J.; Kuroda S.; Smith R.P.; Baser A.; Kalkanli A.; Tadros N.N.; Aydos K.; Mierzwa T.C.; Khalafalla K.; Malhotra V.; Moussa M.; Finocchi F.; Rachman R.I.; Giulioni C.; Avidor-Reiss T.; Kahraman O.; Çeker G.; Zenoaga-Barbăroșie C.; Barrett T.L.; Yilmaz M.; Kadioglu A.; Jindal S.; Omran H.; Bocu K.; Karthikeyan V.S.; Franco G.; Solorzano J.F.; Vishwakarma R.B.; Arianto E.; Garrido N.; Jain D.; Gherabi N.; Sokolakis I.; Palani A.; Calik G.; Kulaksiz D.; Simanaviciene V.; Simopoulou M.; Güngör N.D.; Blecher G.; Falcone M.; Jezek D.; Preto M.; Amar E.; Le T.V.; Ahn S.T.; Rezano A.; Singh K.; Rocco L.; Savira M.; Rajmil O.; Darbandi S.; Sogutdelen E.; Boeri L.; Hernández G.; Hakim L.; Morimoto Y.; Japari A.; Sofikitis N.; Altay B.; Mahmutoglu A.M.; Al Hashimi M.; Ziouziou I.; Anagnostopoulou C.; Lin H.; Shah R.
Format: Article
Language:English
Published: Korean Society for Sexual Medicine and Andrology 2023
Online Access:https://www.scopus.com/inward/record.uri?eid=2-s2.0-85173813215&doi=10.5534%2fwjmh.230076&partnerID=40&md5=35c603cc0e2db03f75f1ec70839b10b4
id 2-s2.0-85173813215
spelling 2-s2.0-85173813215
Agarwal A.; Farkouh A.; Saleh R.; Hamoda T.A.-A.A.-M.; Salvio G.; Boitrelle F.; Harraz A.M.; Ghayda R.A.; Kavoussi P.; Gül M.; Toprak T.; Russo G.I.; Durairajanayagam D.; Rambhatla A.; Birowo P.; Cannarella R.; Phuoc N.H.V.; Zini A.; Arafa M.; Wyns C.; Tremellen K.; Sarıkaya S.; Lewis S.; Evenson D.P.; Ko E.; Calogero A.E.; Bahar F.; Martínez M.; Ambar R.F.; Colpi G.M.; Bakircioglu M.E.; Henkel R.; Kandil H.; Serefoglu E.C.; Alfakhri A.; Tsujimura A.; Kheradmand A.; Marino A.; Adamyan A.; Zilaitiene B.; Ozer C.; Pescatori E.; Vogiatzi P.; Busetto G.M.; Balercia G.; Elbardisi H.; Akhavizadegan H.; Sajadi H.; Taniguchi H.; Park H.J.; Rosas I.M.; Al-Marhoon M.; Gilani M.A.S.; Alhathal N.; Quang N.; Pinggera G.-M.; Kothari P.; Micic S.; Homa S.; Long T.Q.T.; Zohdy W.; Atmoko W.; Ibrahim W.; Sabbaghian M.; Abumelha S.M.; Chung E.; Ugur M.R.; Ozkent M.S.; Selim O.; Darbandi M.; Fukuhara S.; Jamali M.; de la Rosette J.; Kuroda S.; Smith R.P.; Baser A.; Kalkanli A.; Tadros N.N.; Aydos K.; Mierzwa T.C.; Khalafalla K.; Malhotra V.; Moussa M.; Finocchi F.; Rachman R.I.; Giulioni C.; Avidor-Reiss T.; Kahraman O.; Çeker G.; Zenoaga-Barbăroșie C.; Barrett T.L.; Yilmaz M.; Kadioglu A.; Jindal S.; Omran H.; Bocu K.; Karthikeyan V.S.; Franco G.; Solorzano J.F.; Vishwakarma R.B.; Arianto E.; Garrido N.; Jain D.; Gherabi N.; Sokolakis I.; Palani A.; Calik G.; Kulaksiz D.; Simanaviciene V.; Simopoulou M.; Güngör N.D.; Blecher G.; Falcone M.; Jezek D.; Preto M.; Amar E.; Le T.V.; Ahn S.T.; Rezano A.; Singh K.; Rocco L.; Savira M.; Rajmil O.; Darbandi S.; Sogutdelen E.; Boeri L.; Hernández G.; Hakim L.; Morimoto Y.; Japari A.; Sofikitis N.; Altay B.; Mahmutoglu A.M.; Al Hashimi M.; Ziouziou I.; Anagnostopoulou C.; Lin H.; Shah R.
Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
2023
World Journal of Men's Health
41

10.5534/wjmh.230076
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85173813215&doi=10.5534%2fwjmh.230076&partnerID=40&md5=35c603cc0e2db03f75f1ec70839b10b4
Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial. Copyright © 2023 Korean Society for Sexual Medicine and Andrology.
Korean Society for Sexual Medicine and Andrology
22874208
English
Article
All Open Access; Gold Open Access
author Agarwal A.; Farkouh A.; Saleh R.; Hamoda T.A.-A.A.-M.; Salvio G.; Boitrelle F.; Harraz A.M.; Ghayda R.A.; Kavoussi P.; Gül M.; Toprak T.; Russo G.I.; Durairajanayagam D.; Rambhatla A.; Birowo P.; Cannarella R.; Phuoc N.H.V.; Zini A.; Arafa M.; Wyns C.; Tremellen K.; Sarıkaya S.; Lewis S.; Evenson D.P.; Ko E.; Calogero A.E.; Bahar F.; Martínez M.; Ambar R.F.; Colpi G.M.; Bakircioglu M.E.; Henkel R.; Kandil H.; Serefoglu E.C.; Alfakhri A.; Tsujimura A.; Kheradmand A.; Marino A.; Adamyan A.; Zilaitiene B.; Ozer C.; Pescatori E.; Vogiatzi P.; Busetto G.M.; Balercia G.; Elbardisi H.; Akhavizadegan H.; Sajadi H.; Taniguchi H.; Park H.J.; Rosas I.M.; Al-Marhoon M.; Gilani M.A.S.; Alhathal N.; Quang N.; Pinggera G.-M.; Kothari P.; Micic S.; Homa S.; Long T.Q.T.; Zohdy W.; Atmoko W.; Ibrahim W.; Sabbaghian M.; Abumelha S.M.; Chung E.; Ugur M.R.; Ozkent M.S.; Selim O.; Darbandi M.; Fukuhara S.; Jamali M.; de la Rosette J.; Kuroda S.; Smith R.P.; Baser A.; Kalkanli A.; Tadros N.N.; Aydos K.; Mierzwa T.C.; Khalafalla K.; Malhotra V.; Moussa M.; Finocchi F.; Rachman R.I.; Giulioni C.; Avidor-Reiss T.; Kahraman O.; Çeker G.; Zenoaga-Barbăroșie C.; Barrett T.L.; Yilmaz M.; Kadioglu A.; Jindal S.; Omran H.; Bocu K.; Karthikeyan V.S.; Franco G.; Solorzano J.F.; Vishwakarma R.B.; Arianto E.; Garrido N.; Jain D.; Gherabi N.; Sokolakis I.; Palani A.; Calik G.; Kulaksiz D.; Simanaviciene V.; Simopoulou M.; Güngör N.D.; Blecher G.; Falcone M.; Jezek D.; Preto M.; Amar E.; Le T.V.; Ahn S.T.; Rezano A.; Singh K.; Rocco L.; Savira M.; Rajmil O.; Darbandi S.; Sogutdelen E.; Boeri L.; Hernández G.; Hakim L.; Morimoto Y.; Japari A.; Sofikitis N.; Altay B.; Mahmutoglu A.M.; Al Hashimi M.; Ziouziou I.; Anagnostopoulou C.; Lin H.; Shah R.
spellingShingle Agarwal A.; Farkouh A.; Saleh R.; Hamoda T.A.-A.A.-M.; Salvio G.; Boitrelle F.; Harraz A.M.; Ghayda R.A.; Kavoussi P.; Gül M.; Toprak T.; Russo G.I.; Durairajanayagam D.; Rambhatla A.; Birowo P.; Cannarella R.; Phuoc N.H.V.; Zini A.; Arafa M.; Wyns C.; Tremellen K.; Sarıkaya S.; Lewis S.; Evenson D.P.; Ko E.; Calogero A.E.; Bahar F.; Martínez M.; Ambar R.F.; Colpi G.M.; Bakircioglu M.E.; Henkel R.; Kandil H.; Serefoglu E.C.; Alfakhri A.; Tsujimura A.; Kheradmand A.; Marino A.; Adamyan A.; Zilaitiene B.; Ozer C.; Pescatori E.; Vogiatzi P.; Busetto G.M.; Balercia G.; Elbardisi H.; Akhavizadegan H.; Sajadi H.; Taniguchi H.; Park H.J.; Rosas I.M.; Al-Marhoon M.; Gilani M.A.S.; Alhathal N.; Quang N.; Pinggera G.-M.; Kothari P.; Micic S.; Homa S.; Long T.Q.T.; Zohdy W.; Atmoko W.; Ibrahim W.; Sabbaghian M.; Abumelha S.M.; Chung E.; Ugur M.R.; Ozkent M.S.; Selim O.; Darbandi M.; Fukuhara S.; Jamali M.; de la Rosette J.; Kuroda S.; Smith R.P.; Baser A.; Kalkanli A.; Tadros N.N.; Aydos K.; Mierzwa T.C.; Khalafalla K.; Malhotra V.; Moussa M.; Finocchi F.; Rachman R.I.; Giulioni C.; Avidor-Reiss T.; Kahraman O.; Çeker G.; Zenoaga-Barbăroșie C.; Barrett T.L.; Yilmaz M.; Kadioglu A.; Jindal S.; Omran H.; Bocu K.; Karthikeyan V.S.; Franco G.; Solorzano J.F.; Vishwakarma R.B.; Arianto E.; Garrido N.; Jain D.; Gherabi N.; Sokolakis I.; Palani A.; Calik G.; Kulaksiz D.; Simanaviciene V.; Simopoulou M.; Güngör N.D.; Blecher G.; Falcone M.; Jezek D.; Preto M.; Amar E.; Le T.V.; Ahn S.T.; Rezano A.; Singh K.; Rocco L.; Savira M.; Rajmil O.; Darbandi S.; Sogutdelen E.; Boeri L.; Hernández G.; Hakim L.; Morimoto Y.; Japari A.; Sofikitis N.; Altay B.; Mahmutoglu A.M.; Al Hashimi M.; Ziouziou I.; Anagnostopoulou C.; Lin H.; Shah R.
Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
author_facet Agarwal A.; Farkouh A.; Saleh R.; Hamoda T.A.-A.A.-M.; Salvio G.; Boitrelle F.; Harraz A.M.; Ghayda R.A.; Kavoussi P.; Gül M.; Toprak T.; Russo G.I.; Durairajanayagam D.; Rambhatla A.; Birowo P.; Cannarella R.; Phuoc N.H.V.; Zini A.; Arafa M.; Wyns C.; Tremellen K.; Sarıkaya S.; Lewis S.; Evenson D.P.; Ko E.; Calogero A.E.; Bahar F.; Martínez M.; Ambar R.F.; Colpi G.M.; Bakircioglu M.E.; Henkel R.; Kandil H.; Serefoglu E.C.; Alfakhri A.; Tsujimura A.; Kheradmand A.; Marino A.; Adamyan A.; Zilaitiene B.; Ozer C.; Pescatori E.; Vogiatzi P.; Busetto G.M.; Balercia G.; Elbardisi H.; Akhavizadegan H.; Sajadi H.; Taniguchi H.; Park H.J.; Rosas I.M.; Al-Marhoon M.; Gilani M.A.S.; Alhathal N.; Quang N.; Pinggera G.-M.; Kothari P.; Micic S.; Homa S.; Long T.Q.T.; Zohdy W.; Atmoko W.; Ibrahim W.; Sabbaghian M.; Abumelha S.M.; Chung E.; Ugur M.R.; Ozkent M.S.; Selim O.; Darbandi M.; Fukuhara S.; Jamali M.; de la Rosette J.; Kuroda S.; Smith R.P.; Baser A.; Kalkanli A.; Tadros N.N.; Aydos K.; Mierzwa T.C.; Khalafalla K.; Malhotra V.; Moussa M.; Finocchi F.; Rachman R.I.; Giulioni C.; Avidor-Reiss T.; Kahraman O.; Çeker G.; Zenoaga-Barbăroșie C.; Barrett T.L.; Yilmaz M.; Kadioglu A.; Jindal S.; Omran H.; Bocu K.; Karthikeyan V.S.; Franco G.; Solorzano J.F.; Vishwakarma R.B.; Arianto E.; Garrido N.; Jain D.; Gherabi N.; Sokolakis I.; Palani A.; Calik G.; Kulaksiz D.; Simanaviciene V.; Simopoulou M.; Güngör N.D.; Blecher G.; Falcone M.; Jezek D.; Preto M.; Amar E.; Le T.V.; Ahn S.T.; Rezano A.; Singh K.; Rocco L.; Savira M.; Rajmil O.; Darbandi S.; Sogutdelen E.; Boeri L.; Hernández G.; Hakim L.; Morimoto Y.; Japari A.; Sofikitis N.; Altay B.; Mahmutoglu A.M.; Al Hashimi M.; Ziouziou I.; Anagnostopoulou C.; Lin H.; Shah R.
author_sort Agarwal A.; Farkouh A.; Saleh R.; Hamoda T.A.-A.A.-M.; Salvio G.; Boitrelle F.; Harraz A.M.; Ghayda R.A.; Kavoussi P.; Gül M.; Toprak T.; Russo G.I.; Durairajanayagam D.; Rambhatla A.; Birowo P.; Cannarella R.; Phuoc N.H.V.; Zini A.; Arafa M.; Wyns C.; Tremellen K.; Sarıkaya S.; Lewis S.; Evenson D.P.; Ko E.; Calogero A.E.; Bahar F.; Martínez M.; Ambar R.F.; Colpi G.M.; Bakircioglu M.E.; Henkel R.; Kandil H.; Serefoglu E.C.; Alfakhri A.; Tsujimura A.; Kheradmand A.; Marino A.; Adamyan A.; Zilaitiene B.; Ozer C.; Pescatori E.; Vogiatzi P.; Busetto G.M.; Balercia G.; Elbardisi H.; Akhavizadegan H.; Sajadi H.; Taniguchi H.; Park H.J.; Rosas I.M.; Al-Marhoon M.; Gilani M.A.S.; Alhathal N.; Quang N.; Pinggera G.-M.; Kothari P.; Micic S.; Homa S.; Long T.Q.T.; Zohdy W.; Atmoko W.; Ibrahim W.; Sabbaghian M.; Abumelha S.M.; Chung E.; Ugur M.R.; Ozkent M.S.; Selim O.; Darbandi M.; Fukuhara S.; Jamali M.; de la Rosette J.; Kuroda S.; Smith R.P.; Baser A.; Kalkanli A.; Tadros N.N.; Aydos K.; Mierzwa T.C.; Khalafalla K.; Malhotra V.; Moussa M.; Finocchi F.; Rachman R.I.; Giulioni C.; Avidor-Reiss T.; Kahraman O.; Çeker G.; Zenoaga-Barbăroșie C.; Barrett T.L.; Yilmaz M.; Kadioglu A.; Jindal S.; Omran H.; Bocu K.; Karthikeyan V.S.; Franco G.; Solorzano J.F.; Vishwakarma R.B.; Arianto E.; Garrido N.; Jain D.; Gherabi N.; Sokolakis I.; Palani A.; Calik G.; Kulaksiz D.; Simanaviciene V.; Simopoulou M.; Güngör N.D.; Blecher G.; Falcone M.; Jezek D.; Preto M.; Amar E.; Le T.V.; Ahn S.T.; Rezano A.; Singh K.; Rocco L.; Savira M.; Rajmil O.; Darbandi S.; Sogutdelen E.; Boeri L.; Hernández G.; Hakim L.; Morimoto Y.; Japari A.; Sofikitis N.; Altay B.; Mahmutoglu A.M.; Al Hashimi M.; Ziouziou I.; Anagnostopoulou C.; Lin H.; Shah R.
title Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
title_short Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
title_full Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
title_fullStr Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
title_full_unstemmed Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
title_sort Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations
publishDate 2023
container_title World Journal of Men's Health
container_volume 41
container_issue
doi_str_mv 10.5534/wjmh.230076
url https://www.scopus.com/inward/record.uri?eid=2-s2.0-85173813215&doi=10.5534%2fwjmh.230076&partnerID=40&md5=35c603cc0e2db03f75f1ec70839b10b4
description Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial. Copyright © 2023 Korean Society for Sexual Medicine and Andrology.
publisher Korean Society for Sexual Medicine and Andrology
issn 22874208
language English
format Article
accesstype All Open Access; Gold Open Access
record_format scopus
collection Scopus
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    by: Cannarella R.; Shah R.; Abo-Almagd Abdel-Meguid Hamoda T.; Boitrelle F.; Saleh R.; Gul M.; Rambhatla A.; Kavoussi P.; Toprak T.; Harraz A.M.; Ko E.; Çeker G.; Durairajanayagam D.; Alkahidi N.; Kuroda S.; Crafa A.; Henkel R.; Salvio G.; Hazir B.; Darbandi M.; Bendayan M.; Darbandi S.; Falcone M.; Garrido N.; Kosgi R.; Kaiyal R.S.; Karna K.; Ho Vinh Phuoc N.; Birowo P.; Colpi G.M.; de la Rosette J.; Pinggera G.-M.; Nguyen Q.; Zini A.; Zohdy W.; Singh R.; Saini P.; Glina S.; Lin H.; Mostafa T.; Rojas-Cruz C.; Arafa M.; Calogero A.E.; Dimitriadis F.; Kothari P.; Karthikeyan V.S.; Okada K.; Chiba K.; Kadıoglu A.; Altay B.; Turunc T.; Zilaitiene B.; Gokalp F.; Adamyan A.; Katz D.; Chung E.; Mierzwa T.C.; Zylbersztejn D.S.; Paul G.M.; Sofikitis N.; Sokolakis I.; Malhotra V.; Brodjonegoro S.R.; Adriansjah R.; Tsujimura A.; Amano T.; Balercia G.; Ziouziou I.; Deswanto I.A.; Martinez M.; Park H.J.; Bakırcıoglu M.E.; Ceyhan E.; Aydos K.; Ramsay J.; Minhas S.; Hashimi M.A.; Ghayda R.A.; Tadros N.; Sindhwani P.; Ho C.C.K.; Rachman R.I.; Pena M.R.; Motawi A.; Ponnusamy A.K.; Dipankar S.; Amir A.; Binsaleh S.; Serefoglu E.C.; Banthia R.; Khalafalla K.; Basukarno A.; Bac N.H.; Singla K.; Ambar R.F.; Makarounis K.; Priyadarshi S.; Kusuma Duarsa G.W.; Atmoko W.; Jindal S.; Arianto E.; Akhavizadegan H.; Bardisi H.E.; Shoshany O.; Busetto G.M.; Moussa M.; Jamali M.; Al-Marhoon M.S.; Ruzaev M.; Farsi H.M.A.; Mutambirwa S.; Lee D.S.; Kulaksiz D.; Cheng Y.-S.; Bouzouita A.; Sarikaya S.; Kandil H.; Tsampoukas G.; Ala’a F.; Bowa K.; Savira M.; Mogharabian N.; Le T.V.; Harjanggi M.; Anh D.T.; Tien Long T.Q.; Soebadi M.A.; Hakim L.; Tanic M.; Ari U.C.; Parikh F.R.; Calik G.; Vinod K.V.; Dorji G.; Rezano A.; Rajmil O.; Ba Tien D.M.; Yuan Y.; Lizarraga-Salas J.F.; Eze B.; Ngoo K.S.; Lee J.; Arslan U.; Agarwal A.
    Published: (2023)
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    by: Connolly S.J.; Eikelboom J.W.; Bosch J.; Dagenais G.; Dyal L.; Lanas F.; Metsarinne K.; O'Donnell M.; Dans A.L.; Ha J.-W.; Parkhomenko A.N.; Avezum A.A.; Lonn E.; Lisheng L.; Torp-Pedersen C.; Widimsky P.; Maggioni A.P.; Felix C.; Keltai K.; Hori M.; Yusoff K.; Guzik T.J.; Bhatt D.L.; Branch K.R.H.; Cook Bruns N.; Berkowitz S.D.; Anand S.S.; Varigos J.D.; Fox K.A.A.; Yusuf S.; SALA J.; CARTASEGNA L.U.I.S.; VICO M.; HOMINAL M.A.; HASBANI E.; CACCAVO A.; ZAIDMAN C.; VOGEL D.; HRABAR A.; SCHYGIEL P.O.; CUNEO C.; LUQUEZ H.U.G.O.; MACKINNON I.J.; AHUAD GUERRERO R.A.; COSTABEL J.P.; BARTOLACCI I.P.; MONTANA O.; BARBIERI M.; GOMEZ VILAMAJO O.; GARCIA DURAN R.O.; SCHIAVI L.B.; GARRIDO M.; INGARAMO A.; BORDONAVA A.P.; PELAGAGGE M.J.; NOVARETTO L.; ALBISU DI GENNERO J.P.; IBANEZ SAGGIA L.M.; ALVAREZ M.; VITA N.A.; MACIN S.M.; DRAN R.D.; CARDONA M.; GUZMAN L.U.I.S.; SARJANOVICH R.J.; CUADRADO J.; NANI S.; LITVAK BRUNO M.R.; CHACON C.; MAFFEI L.E.; GRINFELD D.; VENSENTINI N.; MAJUL C.R.; LUCIARDI H.L.; GONZALEZ COLASO P.D.C.; FERRE PACORA F.A.; VAN DEN HEUVEL P.A.U.L.; VERHAMME P.; ECTOR B.A.V.O.; DEBONNAIRE P.; VAN DE BORNE P.; LEROY J.E.A.N.; SCHROE H.; VRANCKX P.; ELEGEERT I.V.A.N.; HOFFER E.; DUJARDIN K.A.R.L.; INDIO DO BRASIL C.; PRECOMA D.; ABRANTES J.A.; MANENTI E.; REIS G.; SARAIVA J.O.S.E.; MAIA L.; HERNANDES M.; ROSSI P.; ROSSI DOS SANTOS F.; ZIMMERMANN S.L.; RECH R.; ABIB E., et al.
    Published: (2018)
  • Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices
    by: Gupta S.; Sharma R.; Agarwal A.; Boitrelle F.; Finelli R.; Farkouh A.; Saleh R.; Abdel-Meguid T.A.-A.; Gül M.; Zilaitiene B.; Ko E.; Rambhatla A.; Zini A.; Leisegang K.; Kuroda S.; Henkel R.; Cannarella R.; Palani A.; Cho C.-L.; Ho C.C.K.; Zylbersztejn D.S.; Pescatori E.; Chung E.; Dimitriadis F.; Pinggera G.-M.; Busetto G.M.; Balercia G.; Salvio G.; Colpi G.M.; Çeker G.; Taniguchi H.; Kandil H.; Park H.J.; Rosas I.M.; de la Rosette J.; Cardoso J.P.G.; Ramsay J.; Alvarez J.; Molina J.M.C.; Khalafalla K.; Bowa K.; Tremellen K.; Evgeni E.; Rocco L.; Peña M.G.R.; Sabbaghian M.; Martinez M.; Arafa M.; Al-Marhoon M.S.; Tadros N.; Garrido N.; Rajmil O.; Sengupta P.; Vogiatzi P.; Kavoussi P.; Birowo P.; Kosgi R.; Bani-Hani S.; Micic S.; Parekattil S.; Jindal S.; Le T.V.; Mostafa T.; Toprak T.; Morimoto Y.; Malhotra V.; Aghamajidi A.; Durairajanayagam D.; Shah R.
    Published: (2022)