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    fertility treatments

    Sperm DNA Fragmentation - Factors, Causes, Significance, Tests, and Treatment

    • 32177 views
    • 4.9   (6 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 03 Jan 2019 - Written by Dr. Aarti Sharma - MBBS, DNB, ART - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    Factors which damage of sperm DNA fragmentation are excessive heat, smoking, chemotherapy, chronic infections. Causes of sperm DNA fragmentation includes abnormal spermatid maturation, recreational drugs, advanced chronological age. The different types of Sperm DNA fragmentation test include SCSA, and Sperm Comet Test.

    Let’s Discuss in More Details About Sperm DNA Fragmentation:

    DNA fragmentation is a test for male fertility which measures the amount of damaged DNA in a given sperm sample. DNA fragmentation can occur spontaneously or it can be done intentionally by laboratory personnel. Spontaneous DNA fragmentation is fragmentation that gradually accumulates in a cell. DNA fragmentation is more common among men with sperm motility defects. It is useful for predicting outcomes for In vitro Fertilization (IVF) and its expansion intracytoplasmic sperm injection (ICSI). The main units of measurement are the DFI (DNA Fragmentation Index). The abnormal genetic material present in the sperm, can, in turn, lead to male subfertility, IVF failure, and miscarriage. A conventional semen analysis is done to check the sperm concentration while motility analysis and morphology assessment cannot analyze the sperm at the molecular level hence DNA fragmentation test helps in finding out faulty DNA in sperms. Sperms with high DNA fragmentation fertilizing younger oocytes carry a better prognosis of achieving a successful pregnancy. All men have some amount of damaged DNA in their sperms; higher damage may indicate greater difficulty in achieving pregnancy with IVF and IUI.

    Factors that Damage Sperm DNA

    DNA damage increases with age, men in their 50s or 60s have a higher percentage of sperm fragmentation as compared to men in their 30s or 20s. Other factors that damage sperm DNA include the following:

    • Exposure to various chemicals or toxic agents
    • Excessive heat
    • Chronic infections in the prostate
    • Chemotherapy
    • Radiation or smoking

    In order to prevent further damage to DNA, doctors may recommend drawing sperms directly from testicle with a needle or suggest some antioxidant vitamins that help minimize the damage.

    Causes of Sperm DNA Fragmentation

    One of the major contributing factors for sperm DNA fragmentation is oxidative stress, which can be associated with one or more of the following:

    • Intrinsic causes such as deficiencies in recombination during Spermatogenesis
    • Abnormal Spermatid Maturation
    • Infection and Pyrexia
    • Variations In Sperm Protamine Expression 
    • Abortive Apoptosis
    • Elevated Testicular Temperature
    • Recreational drugs
    • Extrinsic causes like Lapse of Time from the Ejaculation
    • Excessive Smoking and Alcoholism
    • Oxidative Stress and Unhealthy Diet
    • Environmental and Occupational Pollutants
    • Advanced Chronological Age

    Causes of sperm damage

    Who can Benefit from Sperm Fragmentation Test

    The need for Sperm Fragmentation Test arises when there is:

    • Unexplained infertility
    • Arrested embryo development
    • Poor blastocyst development
    • Unsuccessful attempts for IVF and ICSI treatments
    • Miscarriage
    • Advanced chronological age
    • Varicocoele
    • Poor semen parameters
    • Exposure to harmful substances

    The significance of DNA Fragmentation Test

    The fragmentation test can determine what percentage of sperms has fragmentation. Less than 15 percent damage means a very good outcome, while 16 to 29 percent means a moderate outcome. More than 30 percent damage means higher sperm fragmentation that indicates difficulty in achieving a healthy pregnancy, even with IVF. High sperm DNA fragmentation level affects blastocyst development and there are higher chances of failed assisted conception treatment and miscarriage.

    Sperm DNA fragmentation is higher in subfertile men with abnormal sperm parameters; however, men with normal sperm parameters can also develop sperm abnormality. Embryos from sperm with highly fragmented DNA are likely to have a poor prognosis. High level of DNA fragmentation could result in the initiation of natural cellular death (apoptosis) and abnormalities in the offspring. 

    Sper Dna Fragmentation

    Different kinds of Test for Sperm DNA Fragmentation

    There are different types of tests available to assess the percentage of sperms with DNA fragmentation, such as the SCSA, TUNNEL assay and COMET assay. However, the test that has received the most attention is the Sperm Chromatin Structure Analysis (SCSA).

    Sperm Chromatin Structure Analysis (SCSA)

    During the SCSA test, a special dye is allowed to enter into the sperm cell, and the sperm is treated with a chemical. Generally, sperms with fragmented DNA take up more of the dye once it makes its way into crevices in the DNA molecule. With the help of a procedure called flow cytometry, the sperm that takes up lots of dye can be easily be differentiated from the sperm that takes up only a little dye (sperm with normal DNA). Finally, the percentage of each sperm with fragmented DNA can be graphed by using a computer program. A patient with a result of 8.2 percent comes under excellent to good category with 8.2 percent of the sperm cells containing DNA damage. The SCSA test recommends that patients with higher than 25percent should skip IUI and go straight to IVF/ICSI for better results.

    Sperm Comet Test

    Sperm Comet test is a second generation DNA test that provides unique information by measuring the amount of DNA damage in an individual sperm. Sperm Comet results predict the success of infertility treatments and the treatment type most likely to succeed. The percentage of sperm with DNA damage is detected with this test. If the result shows 45 percent damage, shows an average of 45 percent DNA damage in each sperm that was assessed. A flow cytometer is used for monitoring a fluorescent probe that interacts with the DNA molecule.

    Advantages of Sperm DNA Fragmentation Test

    Sperm DNA fragmentation test provides a reliable analysis of sperm DNA integrity that may help to identify men who are at risk of infertility. It also provides information for clinical diagnosis, management, and treatment of male fertility.

    Treatment of High Sperm DNA Fragmentation

    Treatment of High Sperm DNA Fragmentation depends essentially on its causes. If the DNA damage is due to free radicals, lifestyle changes and a healthy diet designed to protect oxidative stress may help reduce the levels of DNA fragmentation.

    Sperm factors

    Other treatment options include the following:

    • Antibiotics in the co-existence of an infection
    • Changes in lifestyle factors known to cause DNA damage such as taking drugs, smoking in both partners, tobacco and occupation
    • Maintaining a healthy diet like eating foods rich in antioxidants, vitamin C & E, eating green vegetables, drinking lots of water,
    • Varicocele surgery
    • Testicular aspiration of sperm may have better DNA integrity than ejaculated sperm since DNA damage occurs at the post-testicular level
    • ICSI Treatment rather than IVF Treatment
    • Antioxidants for three to six months such as astaxanthin either alone or combined with other antioxidants are also known to reduce DNA damage.

    Initiatives can be taken by going through a second test three months later to reduce the levels of DNA fragmentation.

    Doctors may recommend a patient with high level of fragmented DNA to go for ICSI treatment rather than starting with IVF directly. This significantly reduces the length of treatment time and improves the chances of success.

    If you would like to find out more about male infertility assessments, you can consult Ela. Elawoman also provides medical loans at zero percent interest rate for those who need financial help. You can reach us at +917899912611.

    Dr. Aarti Sharma

    Written by

    MBBS, DNB, ART
    Obstetrician, Laparoscopic Surgeon
    Meerut

    Dr. Aarti Sharma is one of the best Gynecologists and Infertility Specialists available in Shastri Nagar, Meerut. She has an experience of almost a decade in the related field and has helped countless infertile couples and women conceive. She has expertise in Gynae Laparoscopy, High-Risk Pregnancy Care, In-Vitro Fertilization(IVF), Gyne Laparoscopy, Hysteroscopy, Treatment of Uterine Abnormalities and growths (Fibroids, Polyps), Irregular Menstrual Cycles, Ovarian Cysts, Vaginal Infections, Intrauterine Insemination (IUI) and many more.
    Dr. Aarti Sharma obtained her academic experience from various recognized institutions. She completed her MBBS from Govt. Medical College, Amritsar in 2006 and further pursued DNB from Subharti Medical College, Meerut, 2010. She also mastered Artificial Reproductive Technique from NUS, Singapore in 2014.
    She incorporates advanced medical equipment and instruments in her practice to perform every procedure with care and precision. Patients from all over the country visit her as she has achieved a consistent rate of success. Moreover, she is a member of Indian Society for Assisted Reproduction (ISAR), Indian Fertility Society (IFS), European Society of Human Reproduction and Embryology (ESHRE) and American Society of Reproductive Medicine. She is registered under 34589 of Medical Council of India (MCI) in 2009.
    Dr. Aarti Sharma was a resident at SIMS and later established her own hospital by the name of Prem Test Tube Baby Center.
    Prem Hospital Test Tube Baby Cente is a Multi-speciality Hospital situated in Shastri Nagar, Meerut. The hospital is specialized in providing infertility treatments such as High- Risk Pregnancy Care, Gyne Laparoscopy, Intra Uterine Insemination (IUI), In Vitro Fertilisation (IVF) and more. Since its establishment in 1994, the hospital has aimed to provide world-class treatment services in obstetrics & gynecology. The hospital caters to the medical needs of the patient with full dedication, precision, and care.
    It also offers focused care for conditions such as high-risk pregnancies.
    The success rates in infertility treatments at this centre are consistently high as they make use of modern equipment and follow advanced methods. The team of dedicated doctors and health-care professionals put all their efforts to provide patients with the utmost care, at affordable costs.
    Prem Hospital Test Tube Baby Center is well-equipped with modern facilities and provides 24-hour assistance along with cab and accommodation facilities for international patients.

    SOURCES AND REFERENCES:

    • Ivf - ivf procedure steps, costs, ivf success rates, types, and faq's  In vitro Fertilization (IVF), Elawoman - 2018
    • Icsi procedure - why it is done? know about azoospermia treatment  ICSI, Elawoman - 2017
    • Know all about intrauterine insemination (iui) - when needed, iui cost, iui risks  IUI, Elawoman - 2017
    • How does cigarette smoking affect fertility - how to conceive if one smokes?  smoking, Elawoman - 2017

    6 Comments

    user_img

    Parth P Verma

    Sperm DNA is affected in a negative way due to different reasons. These factors need to be monitored from time to time so that couples trying for babies can conceive successfully.

    Nov. 26, 2018, 5:32 p.m. 5.0

    user_img

    Manav Pal

    Since I smoked a lot at one point of time, my doctor told me that sperm DNA fragmentation test will contribute to successful guidance towards having a baby.

    Nov. 26, 2018, 10:19 a.m. 5.0

    user_img

    Asmita Rai

    I suffered from miscarriages two times from the time we were trying to conceive a baby. Then, my gynec suggested me to go for sperm DNA fragmentation test. This test helped us in having a successful pregnancy followed by the birth of my baby.

    Nov. 25, 2018, 8:12 p.m. 5.0

    user_img

    Adarsh Bajaj

    I and my wife chose to get sperm DNA fragmentation test done as it was suggested by our infertility specialist. I must say that it proved to be useful for us.

    Nov. 25, 2018, 12:22 p.m. 5.0

    user_img

    Akash V Saluja

    I have read about Sperm DNA Fragmentation test for the first time in my life. Before this, I had heard about this test from one of my friends. We are also planning to go for it and reap the benefits of features associated with the Sperm DNA Fragmentation test.

    Nov. 24, 2018, 4:45 p.m. 5.0

    user_img

    Sushil Lahan

    My doctor has asked me to undergo the Sperm DNA Fragmentation test.

    Nov. 23, 2018, 7:50 p.m. 4.5

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