{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T09:45:47Z","timestamp":1782899147293,"version":"3.54.5"},"reference-count":0,"publisher":"PAGEPress Publications","issue":"2","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Background: Semen cryopreservation is vital for fertility preservation in men with oligoasthenoteratozoospermia (OAT). While cryopreservation increases sperm DNA fragmentation (SDF), patient-specific risk factors in severe OAT remain poorly defined. We aimed to quantify the change in DNA fragmentation index (DFI) and identify clinical predictors of susceptibility.\nMethods: This retrospective cohort study enrolled 340 men with severe OAT (sperm count &lt; 5 million\/mL, total motility &lt; 42%, progressive motility &lt; 30%, morphology &lt; 4%). DFI was assessed in fresh and post-thaw samples using the TUNEL assay. Correlations and multivariate regression analyses evaluated relationships between DFI change and age, body mass index (BMI), sperm parameters, and smoking status.\nResults: The mean DFI increased significantly from 22.0% (IQR 15.0-29.0%) in fresh semen to 36.0% (IQR 23.0-54.0%) postcryopreservation (p &lt; 0.001). The median absolute increase (\u0394DFI) was 9.5% (IQR 6.0-25.0%). Univariate analysis identified significant correlations between the \u0394DFI and higher BMI (\u03c1 = 0.544, p &lt; 0.001), lower sperm count (\u03c1 = -0.638, p &lt; 0.001), and poorer sperm morphology (\u03c1 = -0.669, p &lt; 0.001). In the final multivariate linear regression model, higher BMI and poorer sperm morphology remained the only significant independent predictors of a greater increase in DFI after cryopreservation (both p &lt; 0.001). This model explained 93.7% of the variance in the \u0394DFI (Adjusted R\u00b2 = 0.937, p &lt; 0.001). Age and sperm count were not independent predictors in the final model. Smoking status and varicocele grade were not significantly associated with the \u0394DFI.\nConclusions: Cryopreservation significantly exacerbates sperm DNA damage in severe OAT, but this effect is not uniform. Higher BMI and poorer sperm morphology are independent risk factors for greater damage, identifying a vulnerable patient subgroup. These men may benefit from personalized counseling and optimized cryopreservation protocols to mitigate DNA damage and improve future assisted reproductive technology outcomes.<\/jats:p>","DOI":"10.4081\/aiua.2026.14995","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T07:52:11Z","timestamp":1782114731000},"source":"Crossref","is-referenced-by-count":0,"title":["Body mass index and sperm morphology as independent predictors of increased sperm DNA fragmentation after cryopreservation in men with severe oligoasthenoteratozoospermia"],"prefix":"10.4081","volume":"98","author":[{"given":"Ahmed","family":"Rabie","sequence":"first","affiliation":[{"name":"Alexandria University, Egypt; Northwell Health, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Khalil","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Urology, University of Chicago, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Buscarini","sequence":"additional","affiliation":[{"name":"Mount Sinai, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moustafa","family":"Elsawy","sequence":"additional","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Balah","sequence":"additional","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maida","family":"Bada","sequence":"additional","affiliation":[{"name":"Service of Urology, Hospital Sagrada Familia, Uros Associates, Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Jabbo","sequence":"additional","affiliation":[{"name":"Hamah National Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Zaytoun","sequence":"additional","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,6,22]]},"container-title":["Archivio Italiano di Urologia e Andrologia"],"original-title":[],"link":[{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/14995\/14224","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/download\/14995\/14224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:47:38Z","timestamp":1782895658000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.pagepressjournals.org\/aiua\/article\/view\/14995"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,29]]}},"URL":"https:\/\/doi.org\/10.4081\/aiua.2026.14995","relation":{},"ISSN":["2282-4197","1124-3562"],"issn-type":[{"value":"2282-4197","type":"electronic"},{"value":"1124-3562","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,22]]}}}