The integrity of genetic material in the sperm is crucial for successful fertilization and normal embryo development.
What is DNA Fragmentation Test?
Sperm DNA fragmentation is a term used to denote abnormal genetic material within the sperm, which in turn may lead to male subfertility, IVF failure, and miscarriage. A conventional semen analysis done for sperm concentration, motility analysis, and morphology assessment cannot assess the sperm at the molecular level and detect DNA fragmentation. Therefore, a separate DNA Fragmentation test is required which can be done along with your semen analysis.
How is sperm DNA damaged?
Sperm DNA can be damaged by various factors including:
Most of the factors listed above increase the level of Reactive Oxygen Species (ROS), also known as ‘Free Radicals’. They are located inside the cells in our body and cause ‘Oxidative Stress’ when our cells are no longer able to neutralize them. ROS/Free Radicals cause damage to DNA, proteins, and lipids – which are all essential for healthy sperms.
Advantages of the sperm DNA fragmentation test
-
Provides a reliable analysis of sperm DNA integrity that may help to identify men who are at risk of subfertility.
-
Provides information that helps in the clinical diagnosis, management, and treatment of male fertility.
-
Provides prognostic value in assessing the outcome of assisted conception treatment.
Indications for DNA fragmentation test?
RECURRENT IMPLANTATION FAILURE: Couples undergo IVF or ICSI, this test evaluated the impact of sperm DNA damage or reproductive outcomes (Fertilization, Embryo Development, Pregnancy, and Miscarriage).
UNEXPLAINED INFERTILITY: Test of DNA damage may be predictors of failed natural pregnancy.
IUI FAILURE: High level of DNA damage is associated with repeated IUI failure.
RECURRENT PREGNANCY LOSS: Couples with a history of recurrent pregnancy loss.
TOXINS: Men over 40 years old who are smokers or those exposed to toxics and pollutants.
UROGENITAL INFECTION: Men who have had repeated urogenital infections.
POOR EMBRYO QUALITY: Poor embryo quality observed on the second or third day of self/egg donation cycles.
IDIOPATHIC MALE FACTOR
Treatment of high sperm DNA fragmentation
It depends essentially on the cause. If the damage is caused by free radicals, a change in lifestyle and diet designed to protect against oxidative stress may help reduce the levels of DNA fragmentation.
Other treatment options include:
-
Antibiotics in the co-existence of an infection
-
Lifestyle changes – drugs, smoking, and occupation.
-
Diet – fresh foods, particularly those containing antioxidants and vitamin C & E.
-
Varicocele surgery.
-
Testicular sperm aspiration (TESA) - DNA damage occurs at the post-testicular level; hence testicular sperm may have a better DNA integrity than ejaculated sperm.
-
ICSI rather than IVF
-
Initiatives to reduce the levels of fragmentation can be assessed by undertaking a second test three months later.
What does DNA Fragmentation involve?
It can either done separately or along with your semen analysis.