Sperm motility is the best semen parameter to predict sperm DNA fragmentation

Purpose: Sperm DNA fragmentation (SDF) is associated with male infertility and abnormal semen parameters. However, the effect of SDF on each parameter may differ. In this study, we evaluated the correlation between different semen parameters and SDF to identify the most suitable predictor for abnormal SDF. Materials and Methods: We conducted a retrospective review from a prospective database. Enrollees who underwent conventional semen analysis and an SDF test for medical purposes or elective examinations were enrolled. SDF ≥20% was regarded as abnormal. Spearman correlation coefficient was used to determine the correlations. Area under the receiver operating characteristic curve area under the curve (AUC) was calculated to determine the predictive value. Youden index was used to determine the optimal cutoff value of conventional semen parameters to predict abnormal SDF. Results: In total, 90 men were enrolled, of whom 44 (48.89%) visited for infertility and 51 (56.67%) had abnormal semen analysis. Immotile sperm (IM) and nonprogressive sperm (NPS, NPS = nonprogressive motility + IM) were significantly correlated with SDF (r = 0.50, P < 0.001 for NPS; r = 0.49, P < 0.001 for IM) and were the most predictive for abnormal SDF (AUC = 0.77 for NPS; AUC = 0.78 for IM). By using Youden index, the cutoff values for the prediction of abnormal SDF were 66.37% for NPS and 48.73% for IM. Conclusion: Sperm motility is the most predictive and relevant parameter for the prediction of abnormal SDF. Suboptimal sperm motility should be considered an indication for SDF testing.