Is Sperm DNA Fragmentation(SDF) Testing Still Relevant In Male Infertility diagnosis?
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Semen Analysis Versus Sperm DNA Fragmentation
Semen analysis is an excellent way to test the sperm count, sperm motility and sperm morphology of sperm cells however it gives no information about the DNA contained within the sperm. Semen analysis check how good the sperm are at delivering this parcel i.e. how they can swim, how fast they can move. However if the quality of the goods within is compromised, successful conception may not occur.
The Sperm DNA fragmentation test therefore looks at the quality of the DNA within the sperm. Having high levels of DNA fragmentation can be a major cause of ‘unexplained infertility’, recurrent miscarriage and failed IUI or IVF cycles. It can easily be overlooked because high levels of DNA damage can be present even when sperm look normal i.e. you have a completely normal semen analysis.
Most of the time, the woman is believed to be the guilty one when a pregnancy does not occur or is lost after a perfect semen analysis when it is possible their partner may be experiencing infertility due to high levels of DNA Fragmentation in their sperm. ( You can read this article: Why Has Infertility Been A Source Of Stigma For Women?)
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The male fertility test is a separate test to a semen analysis and identifies if there is DNA damage present within the sperm cells. Your doctor may recommend this fertility test if the male partner is of an increased paternal age, you have experienced recurrent miscarriage, or unexplained fertility issues.
What Is Sperm DNA?
DNA is found in every body cell and carries a genetic code but unlike our other cells, sperm DNA has poor repair mechanisms. If a sperm cell containing damaged DNA fertilises an egg then necessary genetic information may be missing which can lead to poor fertilisation rates, poor embryo development and higher miscarriage occurrence. The good news is, if high levels of DNA Fragmentation are detected this can often be due to underlying causes such as poor diet and lifestyle which, if treated appropriately, can provide successful results.
Causes Of Sperm DNA Fragmentation
Apoptosis
The cells die before completing the process of development and are released with DNA fragmentation due to endonucleases (enzymes which cut DNA).
Oxidative stress
is produced by ROS (reactive oxygen species) which is an unstable molecule containing oxygen and which easily reacts with other molecules in a cell, causing damage to DNA resulting in either single or double-stranded breaks. This can occur in the testes or as the spermatozoa move within the male reproductive tract. It can also occur after ejaculation during the processing of the sperm for various procedures or during cryopreservation (storing and cooling cells at very low temperatures). Many external factors also give rise to reactive oxygen species
- Pyrexia
- Elevated testicular temperature
- Recreational drugs
- infection
- Smoking
- Stress
- Diet
- Advanced chronological age
- Varicocele
- Environmental and occupational pollutants
- Alcohol
Defective chromatin maturation
During spermatogenesis (the development of mature spermatozoa), the chromatin (substance within a chromosome consisting of DNA and protein) does not mature properly and damages are not repaired, leading to less compact DNA which is not well protected against damage by exogenous elements.
Is Sperm DNA Fragmentation Testing Still Relevant In Male Infertility diagnosis?
DNA fragmentation is an important factor in the treatment of male infertility. However, it is still under evaluation and its inclusion in routine semen analysis is debated. DNA fragmentation has been shown to be a robust indicator of fertility potential, more so than conventional semen parameters. Men with high DNA fragmentation levels have significantly lower odds of conceiving, naturally or through procedures such as intrauterine insemination and IVF.
According to this study High SDF levels are seen in men with normal semen parameters, making SDF level a valuable predictor of male fertility status. Studies have demonstrated that SDF levels can be used as a prognostic tool in predicting the likelihood of natural pregnancy and high SDF is additionally associated with recurrent spontaneous abortion (RSA).
Treatment Of Sperm DNA Fragmentation
Is Sperm DNA Fragmentation Testing Still Relevant In Male Infertility diagnosis? Definitely! Below are treatment to SDF
- Male genital tract infection which would give rise to elevated levels of ROS, antibiotics can be used which can cure the underlying infection and thereby reduce elevated Sperm DNA Fragmentation levels.
- Varicocelectomy is a surgery where the enlarged veins in the scrotum are removed. This improves the SDF result.
- Some lifestyle changes can improve SDF levels – quit smoking, giving up alcohol, weight reduction and keeping aloof from radiation and exposure to environmental toxins.
- Shorter ejaculatory abstinence time shows reduction in SDF levels.
- Studies show that antioxidants and Supplements reduce SDF damage. (Click To Buy Spermboost)
High Rates Of Sperm DNA Fragmentation And Pregnancy Potential
- Normal, healthy pregnancies do occur in couples where the male partner has high percentage of sperm with fragmented DNA, although the chances are significantly reduced, as the percentage of sperm bearing low levels of DNA fragmentation is much lower
- Embryos derived from sperm with highly fragmented DNA have poor prognosis
- DNA fragmentation could result in initiation of apoptosis (natural cellular death) and mutations resulting in blastocyst arrest, miscarriage and abnormalities in the offspring
- Sperms with high DNA fragmentation fertilising younger oocytes than older oocytes carry a better prognosis of successful pregnancy, as they are much more efficient at DNA repair of defective sperm
Conclusion
Is Sperm DNA Fragmentation Testing Still Relevant In Male Infertility diagnosis?
Sperm DNA Fragmentation testing is relevant in male fertility diagnosis. It provides a reliable analysis of sperm DNA integrity that may help to identify men who are at risk of subfertility.