Role of Sperm DNA Fragmentation in Male Infertility
By Peter M. Ahlering, MD
Sperm DNA fragmentation is an advanced parameter measuring semen quality and refers to the percentage of sperm showing breaks in the genetic material. It has been shown that 25% of men visiting fertility clinics that have normal semen parameters by the conventional testing, will have considerably high DNA fragmentation compared to fertile male controls. This of course, strongly suggests the importance of testing DNA fragmentation along with the standard semen parameters.
The cause of sperm DNA fragmentation is unknown; however, two things are suspected:
- Excessive accumulation of reactive oxygen species that lead to damage of DNA, generating these breaks in the DNA material.
- Defects in spermatogenesis (sperm formation) that are independent of reactive oxygen species damage.
DNA fragmentation at MCRM Fertility is routinely tested for and has been for many years. We have recognized the importance of measuring these parameters in addition to semen analysis standards such as sperm count, concentration, motility etc. Clearly, abnormalities in DNA fragmentation will affect how one manages treatment options. In the context of in vitro fertilization (IVF), we have the capability of removing DNA fragmented sperm from the pool of cells utilized for selection. In other words, the damaged sperm can be removed from the sample such that they simply cannot be selected when fertilizing the eggs through the process of ICSI. In the context of things such as intrauterine insemination (IUI), some DNA fragmented sperm can be removed with MCRM’s sperm preparation processes, above and beyond the traditional “wash” that is typically utilized for IUI. The ” traditional wash” is simply not good enough.
So, there are definitely male fertility factors beyond a traditional semen analysis to look at in order to properly diagnose the role of the male factor. Testing for sperm DNA fragmentation must be done as it is a common cause of male factor fertility even when normal sperm count, motility, etc. are present.
DNA fragmented sperm can fertilize eggs, but the subsequent embryo development is poor leading to embryo failure, early embryo loss (such as chemical pregnancies or even early miscarriage). Sperm DNA fragmentation does not always lead to infertility, per se, but can contribute to early embryonic failure/miscarriage.
So, no doubt qualitative assessment with DNA fragmentation testing is key in evaluating the male fertility factor.
If you would like to have your sperm DNA fragmentation analyzed or would like to discuss your fertility concerns, contact us TODAY!