Advanced paternal age and sperm DNA fragmentation: A systematic review

Daniel C. Gonzalez, Jesse Ory, Ruben Blachman-Braun, Sirpi Nackeeran, Jordan C. Best, Ranjith Ramasamy

Research output: Contribution to journalArticlepeer-review


Purpose: Male ageing is often associated with defective sperm DNA remodeling mechanisms that result in poorly packaged chromatin and a decreased ability to repair DNA strand breaks. However, the impact of advanced paternal age on DNA fragmentation remains inconclusive. The aim of the present systematic review was to investigate the impact of advancing paternal age (APA) on DNA fragmentation. Materials and Methods: We conducted a thorough search of listed publications in Scopus, PubMed, and EMBASE, in accordance with the PRISMA guidelines. Results: We identified 3,120 articles, of which nineteen were selected for qualitative analysis, resulting in a sample of 40,668 men. Of the 19 articles evaluating the impact of APA on DFI% (DNA fragmentation Index) included, 4 were on Normozoospermic and subfertile men, 3 on normozoospermic, Oligoasthenoteratozoospermic and Teratozoospermic, 6 on fertile and infertile men, 4 on just infertile men, and 2 evaluated a general population. Seventeen of the ninrnteen studies demonstrated APA’s effect and impact on DFI%. Conclusions: Although there was no universal definition for APA, the present review suggests that older age is associated with increased DFI. In elderly men with normal semen parameters, further studies should be performed to assess the clinical implications of DFI, as a conventional semen analysis can often fail to detect an etiology for infertility.

Original languageEnglish (US)
Pages (from-to)1-12
Number of pages12
JournalWorld Journal of Men?s Health
StatePublished - 2021


  • Aging
  • DNA fragmentation
  • Paternal age
  • Sperm parameters

ASJC Scopus subject areas

  • Aging
  • Reproductive Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health
  • Urology
  • Pharmacology (medical)


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