Table 4. Comparison in utility of SDF and perceived drawbacks according to participants’ level of expertise.

Variable	Male infertility cases constitute >50% of patients seen in clinic (n=25), n (%)	Male infertility cases constitute <50% of patients seen in clinic (n=24), n (%)	P value*
Utility of SDF in clinical scenarios
High grade varicocele on physical examination (clinical grades 2/3) with normal semen parameters	12 (48.0)	18 (75.0)	0.05
Low grade varicocele on physical examination (clinical grade 1) with subnormal semen parameters	11 (44.0)	12 (50.0)	0.33
A 35-year-old gentleman presenting with primary infertility who has normal semen parameters and whose partner evaluation fails to identify female factors	14 (56.0)	14 (58.3)	0.44
In a couple presenting with recurrent first trimester natural pregnancy loss	22 (88.0)	19 (79.2)	0.32
In couples presenting with recurrent IUI failure or pregnancy loss following IUI	18 (72.0)	16 (66.7)	0.32
In couples presenting with recurrent conventional IVF failure or pregnancy loss following conventional IVF	23 (92.0)	22 (91.6)	0.48
In couples presenting with recurrent pregnancy loss following ICSI	24 (96.0)	18 (75.0)	0.03
Would a SDF test result affect your decision to utilize testicular instead of ejaculated sperm for ICSI?	15 (60.0)	18 (75.0)	0.13
In a 42-year-old gentleman presenting with infertility and risk factors such as cigarette smoking, obesity and exposure to environmental/therapeutic/occupational gonadotoxins	17 (68.0)	15 (62.5)	0.57
Perceived drawbacks
High cost	10 (40.0)	13 (54.2)	0.21
Poor validation	11 (44.0)	7 (29.2)	0.16
Low precision	4 (16.0)	5 (20.3)	0.3
Low accuracy	4 (16.0)	3 (12.5)	0.38
Long turnaround time	3 (12.0)	3 (12.5)	0.27
Others	6 (24.0)	4 (16.6)	0.29

*, Chi-square. SDF, sperm DNA fragmentation; IUI, intrauterine insemination; ICSI, intracytoplasmic sperm injection; IVF, in vitro fertilization; NPL, natural pregnancy loss.