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If I see enough signs to suggest it is warranted, I will recommend we look at a COMET sperm DNA fragmentation test.
To be fair, it’s an expensive test - so not an easy one to make a decision on, so when would I definitely recommend a sperm DNA fragmentation test?
🔬 If a couple come to me after a long period of trying naturally and she is clearly ovulating regularly.
🔬Early losses or recurrent implantation failure.
🔬 If I see a semen analysis which shows Normal Forms or Morphology at anywhere near 4% (even more so if the defects are mainly head defects).
🔬 If he has ongoing health issues, IBS, autoimmune issues, anything requiring long-term medication.
🔬 If he mentions anything to do with hot balls, achey balls.
🔬 If there is an obvious varicocele - even if they have been told that it won’t impact their fertility!
🔬 If a client comes to me after an unsuccessful IVF cycle (especially if high rate of loss day 3-5).
Some IVF clinics will say it is an unnecessary test because they will ‘just use ICSI anyway’. 😡
But that’s missing the point - check out a recent post by @nurture.hf on Instagram about why it’s such an important test.
If sperm DNA fragmentation is high, several studies show it may be associated with a higher rate of losses in the lab, implantation failure and early loss. Higher sperm DNA fragmentation also has a long term impact on the health prospects of the child, so it the fragmentation is high, it really is worth knowing about and making the effort to try to improve it. There are some studies that refute these links, but the WHO has decided that the balance of evidence suggests the links are probably valid.
In my clinic well over 50% of the couples I see who have been through unsuccessful IVF find they have high sperm DNA fragmentation in play. And a failed IVF cycle seems to be a very expensive way to find this out - so I see a strong argument for checking sperm DNA fragmentation BEFORE EVEN CONSIDERING IVF.
But the IVF clinics are unlikely to tell you that.
Fixing sperm DNA fragmentation is often far cheaper than IVF and can mean IVF is no longer required!). Some common causes of high sperm DNA fragmentation are the presence of a varicocele, an infection in the semen, systemic inflammation, smoking, poor diet, poor insulin control, a history of testicular damage and mumps if it caused testicular pain.
Have you fallen pregnant after improving sperm DNA fragmentation?
I’m a @fertilitysupport trained acupuncturist, we are trained to think outside of the box, question more and dig a little deeper.