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Sperm DNA Fragmentation - is it worth testing??

Updated: 2 days ago


It's men's health week this week - so I thought it was a good time to talk about Sperm - specifically about Sperm DNA fragmentation.


It's having a bit of 'time in the sun' at the moment (it's kind of the popular choice as far as tests go) - especially in couples with unexplained infertility. But what are they actually testing? and why??





What is Sperm DNA Fragmentation?

Sperm DNA fragmentation, refers to damage or breaks in the genetic material of the sperm, and is one of the major causes of male infertility. The causes of this DNA fragmentation might just be something to do with how the sperm making factories were built in the first place, or it could be due to how the sperm mature or genetic alterations, or even due to damage due to various lifestyle factors like smoking, vaping and alcohol, chemotherapy, and even exposure to environmental toxins.

 

Lots of people have been studying sperm DNA fragmentation in the hopes of improving the chances of success in IVF treatments.


In some cases, the oocyte (egg) can repair sperm fragmentation, depending on the type and severity of the damage and the quality of the egg - which is why this can be increasingly as issue as women age (as we know the quality of eggs declines with female age)


What are the symptoms of Sperm DNA Fragmentation?

well, sadly there aren't any.... not obvious ones anyway. The ejaculate will be entirely 'normal' and the semen analysis can also be completely normal. Issues with Sperm DNA fragmentation show up as:

  • longer time to pregnancy,

  • implantation failure and

  • recurrent miscarriage


How do we test it?

It seems simple then to say - Ok - well, let's just do a test and see if it's an issue!!


The problem there though is that there are lots of different tests available!


talks about the causes of sperm DNA fragmentation and the various different ways of testing and shows that there are many different tests and they each look at it in a slightly different way so will each give a different result... which just ADDS to the confusion!


The tests are not really sensitive enough and no one has yet agreed on a cut-off value that is appropriate. Testing can give useful information, but not ALL the information! and the risk is that we return a test result that says there is 'no problem', when perhaps there really is... which makes it very hard to convince the men that they need to make any changes!


I love this 'SWOT' analysis published by Agarwal et al in 2020 (you can find the full article here)



This tells us that Sperm DNA Fragmentation testing can give us useful information in SOME situations, but the quality of the evidence justifying this use is not great and filled with lots of contradictory information.


So for this reason, it's not universally recommended - and add to that, it's expensive!


Alright then - so if we're not going to test it - what should we do?


We make the recommended changes ANYWAY!! They're honestly not that difficult!


Huzzah! Kaboom!! - it's that easy!

Well, in theory it is anyway...


The changes I talk about with my private clients vary depending on their situations, and you should definitely book a time if you think this could be an issue for you, but almost ALWAYS include reducing exposures to environmental toxins. The simple and obvious ones like alcohol, cigarettes and vaping of course, ....but also a heap of less obvious ones like smelly aftershaves, body sprays and even fabric detergent!


We can simplify sperm production to three areas:

  1. the sperm making factory (the seminiferous tubules in the testicles)

  2. the warehouse (the epidydimus)

  3. the delivery system (the vas deferens, the seminal and prostate glands)


and we want to optimise ALL THREE of these in order to ensure that the sperm is the best it can be. Helping the workers in the sperm making factory (the Sertoli Cells) to do their job the best they can, ensuring the environment in the warehouse is just what sperm want (not too hot, not too cold, no radiation) and making sure we aren't adding a heap of toxins to the mix through the delivery system - remember only 5% of the ejaculate is actually sperm - the rest comes from those glands along the way!


Everyone in the world needs to understand more about environmental toxins - they are impacting literally every part of our lives.... and especially our reproduction by interrupting how our hormones work.

Get some help understanding hormones and environmental toxins by heading to my Detox WTF course here (the first session is free to watch!)




Oh, and if you want to understand more about a semen analysis - head to THIS BLOG



REFERENCES


  1. Hamilton TR dos S, Assumpção MEOD. Sperm DNA fragmentation: causes and identification. Zygote. 2020;28(1):1-8. doi:10.1017/S0967199419000595

  2. Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho CL, Henkel R, Finelli R, Leisegang K, Sengupta P, Barbarosie C, Parekh N, Alves MG, Ko E, Arafa M, Tadros N, Ramasamy R, Kavoussi P, Ambar R, Kuchakulla M, Robert KA, Iovine C, Durairajanayagam D, Jindal S, Shah R. Sperm DNA Fragmentation: A New Guideline for Clinicians. World J Mens Health. 2020 Oct;38(4):412-471. doi: 10.5534/wjmh.200128. Epub 2020 Aug 6. PMID: 32777871; PMCID: PMC7502318.



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