Note: I’ve attempted to make the language in this blog post as inclusive as possible of all forms of gender identity, including transgender individuals and individuals with non-binary gender identities. Terms such as “partner or individual who is contributing the egg” or “partner or individual who is contributing sperm” are a little wordy but reflect the wonderful diversity of genders and relationships in family units.
When Sperm Analysis is Not Enough
Most doctors, when trying to determine fertility for a partner or individual who is contributing sperm to a pregnancy, will start with a sperm analysis. The sperm analysis consists of collecting a sample of semen and measuring its volume, how much of the overall volume is actual sperm (rather than the fluid part), how well and how quickly the sperm are able to swim, and what percent of the sperm look “normal”or “abnormal” in shape.
For a lot of people struggling with unexplained infertility, testing on sperm stops there. If all of the metrics in the sperm analysis are normal, that person is no longer poked, prodded, or made to do any uncomfortable procedures, and all of the responsibility ends up put on the shoulders of the partner or individual who is contributing the egg. Not only is this unfair and a source of a lot of emotional upset and self-blame on the part of those individuals, but it also means that a significant factor in “unexplained infertility” is being overlooked.
In fact, in a 2012 study of 239 couples experiencing unexplained infertility, a full 80% were found to have high sperm DNA fragmentation! Not only that, but sperm DNA fragmentation has been indicated as a major cause of miscarriage, especially in the cases of early miscarriage and recurrent pregnancy loss.
So...What is DNA Fragmentation?
A significant percentage of people, even those with normal looking sperm and a normal sperm count, have elevated levels of something called “DNA Fragmentation.” DNA fragmentation is exactly what it sounds like - with this issue, the DNA contained within the head of the sperm is broken and fragmented. It’s normal for a small amount of sperm DNA to be fragmented, even in the healthiest semen. But when the levels start to rise, DNA fragmentation can have a serious negative affect on fertility - it causes lower fertilization rates, early embryo arrest, and can significantly increase risk of miscarriage.
Testing for Sperm DNA Fragmentation
There are several kinds of DNA Fragmentation tests. Two of the more common forms are SCSA, or Sperm Cromatin Structure Analysis, and SCD, or Sperm Chromatin Dispersion. Both of these tests are relatively inexpensive and easy to perform.
What Causes Sperm DNA Fragmentation...and What Can I Do About It?
The most common cause of DNA fragmentation in sperm is the same thing that causes poor egg quality - oxidative stress. A diet high in inflammatory foods and low in antioxidants is often a major contributing factor here, but other issues can also be at play, such as environmental toxins, stress, smoking, and drinking.
The good news is that eliminating these environmental stressors and adopting healthier lifestyle and dietary habits can make a huge impact on sperm DNA Fragmentation (and everything else relating to sperm health and quality!)