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Sperm DNA fragmentation testing is an opportunity to evaluate male fertility beyond semen analysis for those undergoing infertility treatments.
Sperm carries DNA from the male testicles to the female egg. A very large amount of DNA is compacted into each tiny sperm, and the fragile DNA is tightly wrapped around protein structures, which help protect it. Together, the protein structures and DNA form chromatin.
Sperm chromatin is the most compact form of DNA, and even with protection, it is vulnerable to damage during the journey that begins with sperm production in the testicle and extends throughout the epididymis and vas deferens before ejaculation. Some studies show sperm DNA damage, or fragmentation is associated with reduced fertility in men. Extensive DNA fragmentation is associated with infertility and miscarriage and may make both natural conception or conception with IUI more difficult.
Sperm DNA damage has many causes including:
All men have some degree of sperm DNA fragmentation, even those with a normal semen analysis. DNA fragmentation does appear to increase with age so that sperm DNA damage may be higher in older men.
Studies have shown there is a connection between sperm DNA damage and lower male fertility rates. However, the data is less clear when it comes to establishing exact guidelines based on sperm DNA fragmentation testing.
Several testing methods are available to determine sperm DNA integrity including:
The SCSA is the most widely studied DNA integrity test. For this test, sperm is introduced to a special dye, which helps identify damaged DNA.
Men with a normal semen analysis can have sperm DNA damage, just as men with poor sperm quality may have relatively little DNA damage. Fertility rates are lower in men with higher levels of sperm DNA fragmentation.
DNA fragmentation testing may be offered to those diagnosed affected by varicocele, recurrent pregnancy loss, IVF or IUI failure.
Our fertility specialists will review DNA fragmentation test results with the couple and make appropriate recommendations based on the specific situation. However, there are some general guidelines that help to outline the severity of DNA fragmentation and how it may impact fertility.
Basic guidelines for determining fertility potential are as follows:
Some recent studies have shown that even when DNA fragmentation rates are high – more than 30 percent – pregnancy rates may still be comparable to those with excellent sperm DNA integrity when reproductive techniques are used.
Not all conditions that lead to sperm DNA fragmentation can be effectively treated, but when the damage occurs as a result of oxidative stress, diet and lifestyle changes may be helpful.
In cases where a bacterial infection has been confirmed, antibiotics are recommended.
Surgical repair of the varicocele may improve sperm DNA integrity and reduce fragmentation.
Testicular sperm aspiration followed by IVF or ICSI may be recommended to avoid further damage caused by ejaculation.
Contact your local URA clinic in Hasbrouck Heights, Hoboken, and Wayne, NJ for more information. Your friendly URA team will be happy to provide more details on sperm DNA fragmentation and how it would benefit your family.
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