DNA Fragmentation Level in Semen and Its Relation to Couple's Problems and Infertility
Asma Mohammed El-Mahaishi,
Narges Ragab Ben- Halim,
Mohammed Said El-Mahaishi
Background: Male infertility accounts for a substantial proportion of infertility cases globally, with
Libya reporting a notably high prevalence (68.1%). Conventional semen analysis often fails to detect
underlying molecular defects such as sperm DNA fragmentation (SDF), which can impair fertility even
when standard parameters are normal.
Objective: This study aimed to assess the prevalence of high sperm DNA fragmentation index (DFI) and
its correlation with conventional semen parameters, age, smoking, and history of recurrent pregnancy
loss among infertile Libyan men.
Methods: A cross-sectional study was conducted at Lamis Infertility Clinic, Misurata, Libya, including
100 infertile men aged 20–50 years. Semen samples were analyzed according to WHO 2021 guidelines.
Sperm DNA fragmentation was measured using the Sperm Chromatin Dispersion (SCD) test. Statistical
analysis employed Chi-square and Spearman's rank correlation tests, with p < 0.05 considered
significant.
Results: High DFI (>26%) was found in 25% of participants. Significant negative associations were
observed between high DFI and impaired sperm motility (p = 0.013) and abnormal morphology (p =
0.018), though the morphology relationship was complex. Sperm concentration showed no significant
association (p = 0.113). Smoking was significantly associated with high DFI (p = 0.047), with the
highest prevalence among current smokers (36.6%). No significant associations were found with age (p
= 0.295) or recurrent abortion history (p = 0.242).
Conclusion: The 25% prevalence of high DFI confirms its clinical significance in male infertility among
Libyan men. Integrating SDF testing with conventional semen analysis is strongly recommended,
particularly in unexplained infertility, impaired motility, abnormal morphology, and smokers. Smoking
cessation should be prioritized as a modifiable intervention.
