Journal of human reproductive sciences · 2026
The Association of DNA Fragmentation Index, Protamine Deficiency and Basic Semen Parameters: A Cross-sectional Analytical Study.
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Agkas Dimitrios, Tentes Ioannis, Vakalopoulos Ioannis, Asimakopoulos Byron
Аннотация
BACKGROUND: Conventional semen analysis may overlook defects in sperm nuclear integrity, whereas molecular markers such as DNA Fragmentation Index (DFI) and protamine deficiency provide complementary information on sperm chromatin quality.
AIM: The aim of this study was to investigate the associations between conventional semen parameters and two clinically relevant markers of sperm chromatin integrity: DFI and protamine deficiency assessed by chromomycin A3 (CMA3) staining.
SETTINGS AND DESIGN: This was a cross-sectional analytical study conducted in a certified private andrology laboratory operating under standardised quality control protocols.
MATERIALS AND METHODS: A total of 150 men undergoing fertility evaluation between 2022 and 2024 were included. Semen analysis was performed according to the World Health Organization 2021 guidelines;[1] DFI was assessed using the Halosperm sperm chromatin dispersion test, and chromatin maturity was evaluated by CMA3 staining.
STATISTICAL ANALYSIS USED: Non-parametric statistical methods were applied to evaluate correlations between molecular markers (DFI and CMA3) and semen parameters.
RESULTS: Elevated DFI and CMA3 were significantly and inversely correlated associated with total motility, progressive motility, vitality and normal morphology (P < 0.01), while DFI correlated positively with CMA3 positivity (ρ = 0.54, P < 0.001). Men with DFI >30% or CMA3 >40% showed significantly reduced semen quality parameters.
CONCLUSIONS: DFI and CMA3 are strongly associated with key semen parameters and provide complementary information on sperm nuclear integrity with potential clinical relevance in male infertility.
AIM: The aim of this study was to investigate the associations between conventional semen parameters and two clinically relevant markers of sperm chromatin integrity: DFI and protamine deficiency assessed by chromomycin A3 (CMA3) staining.
SETTINGS AND DESIGN: This was a cross-sectional analytical study conducted in a certified private andrology laboratory operating under standardised quality control protocols.
MATERIALS AND METHODS: A total of 150 men undergoing fertility evaluation between 2022 and 2024 were included. Semen analysis was performed according to the World Health Organization 2021 guidelines;[1] DFI was assessed using the Halosperm sperm chromatin dispersion test, and chromatin maturity was evaluated by CMA3 staining.
STATISTICAL ANALYSIS USED: Non-parametric statistical methods were applied to evaluate correlations between molecular markers (DFI and CMA3) and semen parameters.
RESULTS: Elevated DFI and CMA3 were significantly and inversely correlated associated with total motility, progressive motility, vitality and normal morphology (P < 0.01), while DFI correlated positively with CMA3 positivity (ρ = 0.54, P < 0.001). Men with DFI >30% or CMA3 >40% showed significantly reduced semen quality parameters.
CONCLUSIONS: DFI and CMA3 are strongly associated with key semen parameters and provide complementary information on sperm nuclear integrity with potential clinical relevance in male infertility.