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We wondered whether this could be due to estradiol, which is associated with <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content> and reported important for sperm function. Our objective was to investigate the association between estradiol and <jats:styled-content style=\"fixed-case\">DFI<\/jats:styled-content>. In 2008\u20132010, we recruited 284 young men from the general population to deliver samples of semen and blood and answer questionnaires. Serum concentrations of reproductive hormones and <jats:styled-content style=\"fixed-case\">DFI<\/jats:styled-content> were analyzed, the latter using the Sperm Chromatin Structure Assay. Associations were studied using general linear models. The first model utilized metric values of estradiol, whereas the second model compared men with high and low levels, dichotomized by the median value. A possible interaction between estradiol and testosterone was also examined. When investigating metric estradiol levels and <jats:styled-content style=\"fixed-case\">DFI<\/jats:styled-content>, an inverse association was seen without adjustments (<jats:italic>p<\/jats:italic>\u00a0=\u2009.02), but the statistical significance was lost at adjustments for potential confounders (<jats:italic>p<\/jats:italic>\u00a0=\u2009.08). Men with lower estradiol levels (&lt;88\u2009pmol\/L, mean 71\u2009pmol\/L) had a statistically significantly higher <jats:styled-content style=\"fixed-case\">DFI<\/jats:styled-content> than men with higher levels of estradiol (\u226588\u2009pmol\/L, mean 110\u2009pmol\/L). Mean ratio difference was 1.21 (<jats:italic>p<\/jats:italic>\u00a0=\u2009.002) without adjustments and 1.18 (<jats:italic>p<\/jats:italic>\u00a0=\u2009.01) with adjustments. A statistically significant difference in <jats:styled-content style=\"fixed-case\">DFI<\/jats:styled-content> was observed in men with testosterone levels below median when comparing high and low estradiol (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.001). This study supports the idea that serum estradiol levels are protective for sperm <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> integrity, at least at lower testosterone levels.<\/jats:p>","DOI":"10.1002\/em.22500","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T13:01:19Z","timestamp":1660741279000},"page":"268-274","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The association between serum estradiol levels and sperm <scp>DNA<\/scp> integrity"],"prefix":"10.1002","volume":"63","author":[{"given":"Viktor","family":"Lu","sequence":"first","affiliation":[{"name":"Reproductive Medicine Centre Sk\u00e5ne University Hospital  Malm\u00f6 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Svensj\u00f6","sequence":"additional","affiliation":[{"name":"Reproductive Medicine Centre Sk\u00e5ne University Hospital  Malm\u00f6 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