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. 2026 Jul 13;17:1817587. doi: 10.3389/fendo.2026.1817587

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Copyright © 2026 Wang, Xu, Guo, Wang and Jia.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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PRISMA-style flowchart illustrates identification, screening, eligibility assessment, and inclusion of studies for review. Initial pool: 365 records, reduced by exclusions at each step, resulting in 44 included studies with detailed comparisons listed in the final box. — PRISMA flow diagram of article screening for sperm DNA fragmentation review. DGC, density gradient centrifugation; PSU, Pellet Swim-Up; DSU, Direct Swim-Up; DGC-PSU, Swim-Up after DGC; MACS, magnetic-activated cell sorting; MACS-DGC, DGC-MACS, PSU-MACS, MACS-WSU, sequential methods; MFSS, Microfluidic sperm sorting.