Dr. Parviz Kavoussi was interviewed in Fox 7 news regarding the impact of sperm DNA damage on recurrent pregnancy losses. Multiple studies have reported that men with high percentages of their sperm with DNA fragmentation have a higher risk of contributing to recurrent miscarriages. Dr. Kavoussi states, “The good news is now that we can identify a possible cause for some of these couples, there is a lot that can be done at decreasing pregnancy loss rates and improving the odds that the couple is successful with a pregnancy that progresses to live birth.” One known source causing damage to DNA of sperm is infection in the semen. When there is infection, the body tries to fight it with white blood cells. The problem is that white blood cells produce reactive oxygen species, oxygen molecules with unpaired electrons, which damage the DNA in the sperm. Treating the infection with antibiotics can be helpful in reducing this unwanted effect.
The most common identifiable cause of DNA damage in sperm is a varicocele, an anatomic variation of abnormally dilated veins around the testicle. Varicoceles increase DNA damage in sperm and repairing them with minor surgery can decrease the level of DNA damage in the sperm 3 months following surgery. Dr. Kavoussi has specialty fellowship training in microsurgical varicocele repairs. The theory is that varicoceles increase reactive oxygen species production and the team at Austin Fertility & Reproductive Medicine/Westlake IVF is currently performing a clinical trial to further evaluate this in efforts to advance the field and provide more options for the couples going through these challenging scenarios.
When a source of the elevated levels of DNA damage cannot be identified, an option to consider, with more compiling data supporting it, is a direct testicular sperm retrieval. It is well established that sperm in the semen always have a higher level of DNA damage than testicular sperm. The question is whether that level of DNA damage is high enough to warrant a testicular sperm retrieval in couples with recurrent pregnancy losses. Sperm retrieved from the testicle is used with in vitro fertilization (IVF) to help reduce the miscarriage risk.
The high level andrology laboratory at Westlake IVF performs complex testing on sperm beyond the basic semen analysis, including testing the integrity of the DNA of the sperm with DNA fragmentation indices. To read more about this testing at Westlake IVF, click here