DNA fragmentation index and its correlation with other sperm parameters in 4833 infertile males

Priya S. Patil, Satish M. Patki, Shweta S. Patki, Ujjwala S. Patki


Background: Semen analysis forms the basic investigation for male factor of infertility. According to WHO Manual sperm values of normalcy are decreasing. Recent studies have highlighted newer parameters of sperm playing their role in the outcome of pregnancy. The aim was to study the DNA fragmentation index (DFI) and to know its correlation with other sperm parameters.

Methods: A total of 4833 cases underwent routine semen analysis along with the DFI. The statistical analysis was done using SPSS using t test and ANOVA test.

Results: It was observed that 52% infertile males presented late for treatment. All parameters showed a decline with advancing age. There was definite correlation between sperm count and sperm motility as well as morphology. The DFI showed significant negative correlation with sperm count. Pearson correlation showed positive correlation between DFI and sperm motility and morphology.

Conclusions: The study highlights the need for increasing awareness about male factor of infertility. A thorough semen analysis along with DFI can help the clinician to explain the couple in a better way about the choice of ART and success of treatment.


DFI, Progressive sperm motility, Sperm concentration, Sperm morphology

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Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: a review of literature. J Hum Reprod Sci. 2015;8(4):191-6.

Kumar D. Prevalence of female infertility and its socio-economic factors in tribal communities of Central India. Rural Remote Health. 2007;7:456.

Zargar AH, Wani AI, Masoodi SR, Laway BA, Salahuddin M. Epidemiologic and etiologic aspects of primary infertility in the Kashmir region of India. Fertil Steril. 1997;68:637-43.

Ahmad MO, Khan SA, Hameed MA, Khan UA. A Study of Sperm Morphology in a Pakistani Population. Pak J Physiol. 2007;3(2).

World Health Organization. (‎2010)‎. WHO laboratory manual for the examination and processing of human semen, 5th ed. Geneva: World Health Organization Available at

Clinical Atlas of Sperm Morphology: Achyut M. Phadke, First Edition, 2007, Jaypee Brothers, New Delhi, India.

Patil P, Bambulkar S, Ajgaonkar S, Patil R, Patil A, Nikam V. DNA fragmentation index [DFI] of human semen by modified aniline blue method. Cibtech J Bioprotocols. 2013;2(3):1-5.

Joshi P, Gopal N, Bhat V. Study of semen analysis patterns in infertile males. Int J Pharm Bio Sci. 2011 Jan;1(1):44-9.

Kovac JR, Addai J, Smith RP, Coward RM, Lamb DJ, Lipshultz LI. The effects of advanced paternal age on fertility. Asian J Andrology 2013;15(6):723-8.

Luna M, Finkler E, Barritt J, Barchama N, Sandler B, et al. Paternal age and assisted reproductive technology outcome in ovum recipients. Fertil Steril. 2009;92:1772-5.

Adiga SK, Jayaraman V, Kalthur G, Upadhya D, Kumar P. Declining semen quality among South Indian infertile men: a retrospective study. J Hum Reprod Sci. 2008;1:15-8.

Mukhopadhyay D, Varghese AC, Pal M, Banerjee SK, Bhattacharyya AK, Sharma RK, et al. Semen quality and age-specific changes: A study between two decades on 3,729 male partners of couples with normal sperm concentration and attending an andrology laboratory for infertility-related problems in an Indian city. Fertil Steril. 2010;93:2247-54.

Jørgensen N, Joensen UN, Jensen TK, et al. Human semen quality in the new millennium: a prospective cross-sectional population-based study of 4867 men. BMJ Open 2012;2:e000990.

Nikbakht R, Saharkhiz N. The influence of sperm morphology, total motile sperm concentration of semen and the number of motile sperm inseminated in sperm samples on the success of intrauterine insemination. Int J Fertil Steril. 2011;5(3):168-173.

Nordhoff V, Fricke RK, Schüring AN, Zitzmann M, Kliesch S. Treatment strategies for severe oligoasthenoteratozoospermia (OAT) (<0.1 million/mL) patients. Andrology. 2015 Sep;3(5):856-63.

Kovac JR, Smith RP, Cajipe M, Lamb DJ, Lipshultz LI. Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction. Asian J Androl. 2017;19(1):39-42.

Franco Jr JG. Sperm DNA fragmentation. Translational Androl Urol. 2017;16;6(4):S516-8.

Agarwal A, Majzoub A, Esteves SC, et al. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Transl Androl Urol. 2016;5:935-50.

Sakkas D, Alvarez JG. Sperm DNA fragmentation: mechanisms of origin, impact on reproductive outcome, and analysis. Fertil Steril. 2010;93:1027-36.