Almost 15% of infertile males have normal semen parameters and DNA Fragmentation Index (DFI) could be reasonably a valued tool for fertility extrapolation than the conventional semen analysis. To the best of our knowledge, this is the first study to assess the prevalence of high DFI in Saudi infertile men with normal standard semen parameters in order to support the generalizability about sperm DFI as a marker of male infertility. A total of 79 infertile men with normal semen standards were identified (study group). Standard semen analysis and sperm chromatin dispersion were carried out. 33 men (41.8% of the whole study group) had a DFI ≥ 20%; with 19 men (24.1%) (95% CI: 14.67-33.53) had a 20% ≤ DFI<30%, and 14 men (17.7 %) (95% CI: 9.28-26.12) had a DFI ≥ 30%. The mean DFI was 21.14% (±10.26%) with a median of 18.12% [5.09-57.23]. Our findings showed that a considerable proportion of men with normal semen parameters had high sperm DNA damage levels. Thus, the DFI by sperm chromatin dispersion test is essential to explain causes of infertility in cases where semen analysis has not shown any deviation from the norms.
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