Are you struggling to grow your family? Did your semen analysis come back normal or only slightly abnormal and your doctors are scratching their heads? This can be so frustrating! Have you done a test for Sperm DNA Fragmentation?
Sperm DNA Fragmentation
If you dive into the research, what you’ll find is a load of data showing that despite a ‘normal’ semen analysis and karyotype there can be damage to sperm’s genetic makeup, this is called DNA fragmentation. This key information is missed in a standard fertility workup because it’s not part of it. WHAT?!?
Sperm DNA Fragmentation is separation or breakage within the DNA or genetic building blocks. This damage may not change the shape, motility, count, or even the ability of a sperm cell to fertilize an egg. However, it can interrupt the development of an early embryo, making it incompatible with continued development and will ultimately lead to loss.
Sperm DNA integrity is essential to embryo proliferation!
DNA Fragmentation can happen during spermiogenesis (the development and maturation of baby sperm into fully functioning adult sperm) or en route from the testicles into the ejaculate due to oxidative stress.
How Is Sperm DNA Fragmentation Tested?
There are a only few specialty labs in the US that offer an assessment of Sperm DNA Fragmentation. Most fertility clinics have access to these labs and can help with the proper collection and transport of your specimen, which is critical for adequate testing. However, if you’re in a real bind and don’t have a fertility specialist or can’t find one willing to order the test for you. You can order it yourself!
Unfortunately, the American Society for Reproductive Medicine (ASRM) does not currently recommend routine testing for DNA Fragmentation for infertility or pregnancy loss. I imagine this will change in the coming years. The European Society of Human Reproduction and Endocrinology (ESHRE) guidelines do recommend the assessment of sperm DNA fragmentation in situations like recurrent pregnancy loss. I’ve thankfully seen this testing being used more routinely in the last couple of years.
What Causes Sperm DNA Fragmentation?
- Age
- Alcohol
- Caffeine
- Electromagnetic Radiation
- Environmental Toxins
- BPA
- Phthalates
- Pesticides, etc.
- Heat
- Fever
- Hot Tubs
- Prolonged & Frequent Exercise In Tight Clothing
- Sauna
- Obesity
- Oxidative Stress
- Smoking
- Varicoceles
This is not an exhaustive list, as I’m sure there are many possibilities yet unknown.
What Can Be Done About Sperm DNA Fragmentation?
Good news! Many of the potential causes of Sperm DNA Fragmentation and poor sperm health are modifiable. Men are making new sperm all the time. In fact, the development and maturation of sperm is around 75 days. So, if you’re experiencing infertility or loss, you could start with the suggestions below to really boost sperm health.
Lifestyle Changes
- Stop smoking
- Eliminate use of illicit and recreational drugs
- Yes, that definitely means marijuana in all of it’s forms
- Reduce BPA Exposure
- Eliminate plastic food and drink containers
- Don’t touch thermal receipts
- Ditch food in metal cans (the lining is often coated with BPA)
- Food should NEVER be heated in plastic
- The dishwasher is too hot for plastic
- Reduce Phthalate Exposure
- See the info above about plastic
- Don’t use vinyl flooring in your home
- Avoid anything with fragrance, perfume, and parfum (perfumes, air fresheners, cleaning products, personal care products, etc.)
- Choose personal care products that don’t contain phthalates
- Avoid pesticides, herbicides, insecticides, and fungicides
- Filter shower and bathing water
- Maintain an optimal body weight
- BMI 20-25
- Don’t use your laptop on your lap
- Find a place for your phone away from your body and out of your pants pocket
- Keep your testicles cool
- No hot tubs, hot baths, heating pads, electric blankets, heated seats
- Wear loose-fitting underwear and pants
- Reduce time in tight-fitting short and/or on a bike seat
Nutrition
- Eliminate alcohol and caffeine
- Filter your drinking and cooking water
- Organic food is your best choice
- Choose a diet rich in colorful fruits and vegetables (8-10 servings a day)
- Supplement with targeted antioxidants and mitochondrial support
- CoQ10
- Glutathione
- NAC
- Selenium
- Vitamin E
- Vitamin C
- Zinc
- Alpha Lipoic Acid
- Carnitine
Help From Your Doctors
Additionally, there are some things your doctor could help with if you have DNA Fragmentation:
- Varicocele repair if appropriate
- Certain sperm preparations for IUI and IVF show less damage to sperm
- TESE (testicular sperm extraction)
Sperm DNA Fragmentation is REAL and it’s rampant! Be your own best advocate and request this testing. The few extra hundred dollars and a bit more effort are worth it. If it comes back that the DNA Fragmentation Index is high, include some of these recommendations or work with someone who can help. The onus should not always be on the person with the uterus. Remember this is a team sport.
Sending so much love and baby dust!
XO,
Tamara
You Don’t Have To Do This Alone!
If you’re thinking about getting pregnant or struggling with fertility, consider working with a holistically-minded provider who can offer a thorough assessment of your whole health and provide personalized therapeutic options. You don’t have to do this alone! 🙂
I always hope that my posts are supportive of your journey. There are additional resources and references below. Leave me a comment, check back often, and reach out if you need a partner in this process! Thanks so much for reading.
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REFERENCES
- Agarwal A, Cho CL, Majzoub A, Esteves SC. Call for wider application of sperm DNA fragmentation test. Transl Androl Urol. 2017 Sep;6(Suppl 4):S399-S401. doi: 10.21037/tau.2017.03.64. PMID: 29082937; PMCID: PMC5643632.
- Eisenberg ML, Sapra KJ, Kim SD, Chen Z, Buck Louis GM. Semen quality and pregnancy loss in a contemporary cohort of couples recruited before conception: data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study. Fertil Steril. 2017 Oct;108(4):613-619. doi: 10.1016/j.fertnstert.2017.07.008. Epub 2017 Aug 30. PMID: 28863939; PMCID: PMC5657506.
- Khandwala YS, Eisenberg ML. Practical applications of sperm DNA fragmentation testing and its role in infertility. Transl Androl Urol. 2017 Sep;6(Suppl 4):S397-S398. doi: 10.21037/tau.2017.03.28. PMID: 29082151; PMCID: PMC5643692.
- McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril. 2019 Jul;112(1):54-60.e3. doi: 10.1016/j.fertnstert.2019.03.003. Epub 2019 May 2. PMID: 31056315.
