Strategies for Reducing Sperm DNA Fragmentation in ICSI Semen Samples: a Prospective Randomized Controlled Trial

Inclusion Criteria: * Male partner with abnormal sperm DNA fragmentation index (\>20%) by TUNEL assay * Male partner with at least 1 million progressive motile count * Male aged 18-50 years * Male with adjusted sexual abstinence days (1-2 days) * Female aged 18-37 years * Normo-responder females (at least 5 mature oocytes) Exclusion Criteria: * Leukocytospermia * Varicocele * Known genetic abnormality * Use of oocyte or sperm donors * Use of a gestational carrier * Presence of any endometrial factors that can affect embryo implantation * Any contradictions to undergoing in vitro fertilization or gonadotropin stimulation