As male factor contributes to 60% of couples struggling with infertility, we have been striving for better ways to evaluate the subfertile male. The standard evaluation of the male partner includes a semen analysis which assesses the sperm count, motility (percent moving), forward progression (percent swimming in a linear, rapid, directional manner), and morphology (percentage of sperm cells with normal shapes). Although the semen analysis is the basic laboratory evaluation, it is being found to be a relatively crude assessment of a man’s fertility. At Westlake IVF’s andrology laboratory, we are able to evaluate the extent of sperm DNA fragmentation (SDF) by testing to see what percent of a man’s sperm cells have damaged DNA, which may impact fertility by hindering fertilization, early embryo development, implantation, pregnancy, and maintenance of pregnancy.
Factors that can increase the level of SDF include: environmental toxins, chemotherapy, radiation therapy, drugs, cigarette smoking, high fevers, and varicoceles (abnormally dilated veins around the testicle). A number of research studies have associated varicoceles (which are found in 40% of men with infertility) with higher levels of SDF. Multiple studies have shown that surgically repairing varicoceles can reduce SDF and improve pregnancy rates. Therefore, at Austin Fertility & Reproductive Medicine, SDF testing is offered for subfertile men with varicoceles. There has also been data correlating increased levels of SDF in couples with unexplained infertility and couples who have had recurrent pregnancy losses (miscarriages). There are also studies suggesting that high levels of SDF may be associated with pregnancy losses after IUI or IVF, so these couples may elect to have SDF testing. It is suggested that SDF testing should be considered in couples who have failed recurrent IVF cycles, especially when there is not a significant concern about female factors or eggs. As higher levels of SDF are found in ejaculated sperm than from sperm retrieved directly from the testicle, sperm retrievals are recommended for couples who are undergoing IVF when the male partner has been identified to have high levels of SDF.
At Austin Fertility & Reproductive Medicine/Westlake IVF, SDF testing is offered to select patients when indicated, to help improve the couples odds of conceiving and maintaining their pregnancy to term.