Do we need to do a DNA analysis of sperm fragmentation?

In recent years, promising studies have been presented on the association between DNA damage and poor IVF outcomes (low blastulation rate (no embryos on day 5 of development), no implantation, all obtained embryos are aneuploid (with impaired chromosome set) after PGT-A). This breakthrough led to the introduction of a test for the integrity of sperm DNA in tandem with the spermogram. Sperm DNA integrity is crucial for the proper release of paternal genetic material into the oocyte and the further development of the embryo and subsequent implantation. However, there are many articles today that connect the successful completion of infertility treatment to the integrity of DNA, leading to conflicting data, often extremely difficult to interpret and limited in clinical evidence.

Analysis for DNA damage of sperm can be classified by:

  • molecular basis of analysis
  • type of DNA damage
  • parameters measured by the analysis.

Sperm DNA fragmentation in men with infertility is mainly due to bad habits and increased oxidative stress, according to scientific studies.

The following types of tests are currently available to detect sperm DNA damage:

  • analysis of the final labeling with deoxyuridine (TUNEL) is a direct assessment of DNA damage (detects actual breaks in DNA chains)
  • indirect evaluation with FISH
  • analysis for sperm chromatin dispersion (SCD)
  • flow cytometry of sperm chromatin structure (SCSA)
  • test for sperm DNA fragmentation (SDFA).

The DNA fragmentation index is the percentage of the population of sperm with medium and high DNA damage. It is calculated by establishing the ratio of fragmented cells to the total number of cells.

An analysis of the literature shows that there is currently a lack of agreement with the standardization of test protocols, and that there are many interlaboratory variations and a wide range of thresholds, which limits the understanding of what each DNA measurement fragment actually measures (Barratt CLR and De Jonge). CJ., 2010; Zini A. and Sigman M. 2009).

Collins et al. (2008) concluded that the assessment of sperm DNA damage is not strong enough to state with certainty any clinical benefit of these tests for the assessment of infertile men. In cases where a man wanted to pass this test, and after it was found a high percentage of fragmentation of sperm DNA, it can be concluded that the prognosis for the success of the program will be minimal. However, the American Society for Reproductive Medicine (ASRM) alternatively concluded that the available data do not support a consistent link between DNA integrity disorders and the results of IVF cycles.

It should be noted that currently no studies can find a correlation between embryo quality and DNA fragmentation, as well as the adequacy of predictions of clinical pregnancy.

The use of a test that examines DNA fragmentation of sperm as part of a man’s examination in IVF programs cannot be recommended because the confusion of its relationship to an increased risk of failure is not convincing.

The experienced and competent team of Reprolife Clinic recommends only the most necessary tests and research that have a scientific basis.

We can lead you to the dream of becoming a parents!