Clinical Significance of Combining DNA Fragmentation Index with Routine Semen Analysis in Male Infertility Workup: A Multicenter Retrospective Study

Background: Routine semen analysis is the standard diagnostic tool for evaluating male infertility, but it may not detect functional sperm defects such as DNA damage. Sperm DNA fragmentation index (DFI) has emerged as a clinically relevant marker associated with reduced fertility outcomes. Objective: To assess the clinical significance of integrating DFI testing with routine semen analysis in infertile males. Methods: This multicenter retrospective study was conducted across infertility laboratories in Chhattisgarh, Madhya Pradesh, and Maharashtra over one year. A total of 220 infertile men were included. Semen analysis was performed according to WHO guidelines, and DFI was assessed using standardized sperm DNA fragmentation testing. Participants were categorized into low DFI (