Objective:  To evaluate levels of sperm nuclear DNA damage in infertile men with normal and abnormal standard semen parameters.

Design:  Prospective study.

Setting: Male infertility clinic.

Patient(s):  Ninety-two men seeking infertility treatment and 16 fertile volunteers.

Intervention(s): Standard semen analysis was performed according to the World Health Organization guidelines.

Main Outcome Measure(s):  Sperm DNA damage was assessed by sperm chromatin structure assay and the results expressed as %DFI.

Result(s):  Of the 92 patients, 21 (23%) had normal standard sperm parameters (concentration, motility, and normal sperm forms), while 71 (77%) had an abnormality in one or more of these parameters. The %DFI [median (25th and 75th percentiles)] in infertile men with normal sperm parameters [23 (15, 32)] was significantly higher than fertile donors [15 (11, 20)] (P =  .02), but not significantly different from infertile men with abnormal sperm parameters [28 (18, 41)] (P =  .27).

Conclusion(s):  The results of this study indicate that a significant increase in SCSA-defined DNA damage can be found in sperm from infertile men with normal standard sperm parameters. Therefore, sperm DNA damage analysis may reveal a hidden abnormality of sperm DNA in infertile men classified as idiopathic based on apparently normal standard sperm parameters.