Sperm DNA Fragmentation: Causes & Treatment

Did you know that up to 40% of male infertility cases may be linked to sperm DNA damage, yet most men never get tested for it? Very few clinics in Mumbai actually recommend DNA fragmentation testing to couples with unexplained infertility, and even fewer actually possess the equipment to test for it.
In this blog, we will cover what sperm DNA fragmentation is, its causes, and how to improve sperm quality through treatment and lifestyle changes.

What is DNA Fragmentation in Sperm?

Sperm DNA fragmentation refers to damage or breaks in the genetic material of sperm cells.

Sperm DNA decondensation is an integral step in fertilization when the tightly packed DNA within the sperm head unravels and fuses with the egg’s genetic material. When errors occur in this process, DNA becomes prone to breaks that remain unrepaired, which results in fragmentation. 

Without proper decondensation, the proper fertilization cannot take place, which affects embryo development. Sperm fragmentation may be caused due to intrinsic (internal) reasons or external causes like chemotherapy, heat, infections, etc.

How is Sperm DNA Fragmentation Tested?

The sperm DNA fragmentation index (DFI) is used to measure the extent of damage to the sperm’s DNA. Here are the various testing methods used:

(1) Sperm Chromatin Structure Assay (SCSA)

SCSA evaluates sperm DNA integrity by using a special dye called acridine orange that binds differently to broken and intact DNA. Intact DNA glows green, while fragmented DNA appears red.

(2) Sperm Chromatin Dispersion (SCD)

In this test, sperm is exposed to a denaturing solution that removes nuclear proteins. If the DNA is intact, it disperses and forms a visible halo around the sperm head.

(3) TUNEL Assay

The TUNEL test detects DNA strand breaks in sperm. It works by attaching fluorescently labeled nucleotides to the ends of broken DNA strands. Under a fluorescence microscope, damaged sperm cells light up.

(4) Comet Assay

The Comet Assay involves embedding sperm cells in a gel on a microscope slide and applying an electric field. If the DNA is damaged, fragments migrate out of the sperm head and form a shape that looks like a comet.

Why Would Sperm DNA Fragmentation Testing Be Useful?

A healthy, high-quality embryo requires genetic matter from both the egg and the sperm. Most fertility clinics will only test semen for motility (activeness) and morphology (shape), while oocytes are extensively tested for a wide range of parameters. However, semen analysis is not a reliable method of diagnosing infertility in men.

Sperm fragmentation testing is so overlooked that many couples with undiagnosed infertility go through multiple cycles of fertility treatment before even testing for DNA fragmentation. Infertile men are more likely to have sperm DNA fragmentation, which may contribute to low fertility rates and pregnancy complications.

Sperm DNA fragmentation has no symptoms, as it only affects the DNA of your sperm cells. You may be asked to undergo diagnostic testing for sperm fragmentation if you struggle with unexplained infertility or your partner has suffered from several miscarriages.

Treatments For Sperm DNA Fragmentation

To address DNA fragmentation, some IVF centers, including Corion, now offer advanced sperm sorting technologies.

At Corion, we offer two advanced treatments to help our patients overcome infertility caused by high DNA fragmentation. At our IVF clinic in Andheri, we provide Microfluidics (Sperm Cell Sorter) and Positive Rheotaxis Extended Drop techniques for sperm separation at highly affordable rates.

Techniques like the swim-up and centrifugal methods fail to test sperm for DNA integrity and are also not very accurate at identifying the most motile sperm. These methods tend to select highly fragmented sperm, which can affect the quality of embryos. Furthermore, these techniques may also cause damage to the sperm cells. This is where microfluidics comes in.

Microfluidics

Microfluidic sperm-sorting devices use laminar flow to identify sperm that have a greater chance of high DNA fragmentation and separate them from healthy sperm.

Although microfluidics is more expensive than other sperm sorting techniques, it offers greater accuracy and, unlike traditional methods like centrifugation, does not cause mechanical or chemical damage to sperm cells. This is why it is highly recommended for men with low semen parameters, as their sperm is already moderately damaged.

Positive Rheotaxis Extended Drop

Sperm rheotaxis refers to the ability of sperm cells to align their swimming direction with or against fluid flow. Positive Rheotaxis Extended Drop (PRED) is an innovative sperm sorting technique that separates healthy sperm on the basis of their natural swimming movement.

PRED can identify the sperm with the best shape, motility, and chromatin maturity for ART treatments. In PRED, sperm samples are placed in a microfluidic device that creates a controlled flow of fluid. The highest-quality sperm swim against the flow and are collected in a separate area from the low-quality sperm.

Causes of DNA Fragmentation

DNA fragmentation treatment involves making lifestyle changes to increase the quality of your sperm. While you cannot prevent DNA fragmentation, there are certain things you can do to reduce it.

The male body creates new sperm every 72 days, which means that if you follow certain treatments and make lifestyle changes, you can definitely reduce the percentage of DNA fragmentation in your sperm. Here are some of the main DNA fragmentation causes and what lifestyle changes you can make to treat them.

High Testicular Temperature

High testicular temperature is associated with decreased sperm quality in men.

Cool Down

Avoid raising your testicular temperature. Do not take hot baths or visit hot tubs, saunas, etc. While using a laptop, keep it on a desk or table and never on your lap.

Wear loose underwear and swap out those briefs for boxers. You can even start sleeping naked to reduce your testicular temperature.

Unhealthy Diet

Eating unhealthy food can affect your sperm count and quality. Eating junk food and compromising on important food groups can cause sperm fragmentation.

Fix Your Diet

Eat a healthy and balanced diet that contains foods rich in antioxidants, vitamins C and E, selenium, zinc, folate, and omega-3 fatty acids.

Supplements

Various Nutracitical supplements like L-carnitine, omega-3, and coenzyme Q10, as well as antioxidants containing vitamin C, vitamin E, and zinc are available Over the Counter. Take guidance from your Fertility Specialist or Doctor prior to starting on any. Targeting sperm health with male fertility supplements can also help reduce DNA fragmentation.

Infections

Infections in the reproductive tract and prostate can cause greater levels of DNA fragmentation. Genitourinary infections caused by Chlamydia trachomatis and Mycoplasma are known to increase sperm DNA fragmentation. Gonorrhea and prostatitis can also negatively impact DNA integrity.

Get Treated

Get any infections and STIs checked by a fertility specialist and follow treatment protocols.

Varicocele

A varicocele is an enlarged vein in the scrotum. The presence of varicoceles can impact the health of the sperm by altering the expression of proteins in their seminal plasma, thereby causing oxidative stress. They also increase testicular temperature.

Varicocele Treatment

Consult a urologist and treat the varicocele before you try for pregnancy. Research has shown that 50%–70% of patients observe an improvement in sperm quality after correcting the varicocele.

Lifestyle Factors

Smoking and drug use introduce toxins to the body, while excessive alcohol consumption increases oxidative stress. This results in damage to sperm DNA.

Make Lifestyle Changes

Avoid smoking and drug use, and limit or quit alcohol consumption to drastically improve the quality of your sperm.

Medical Treatments

Cancer and cancer treatments such as radiation and chemotherapy can affect the health of your sperm. Certain medications like SSRIs can also have the same effect.

Check Your Meds

Speak to a fertility specialist about the medication you’re on, and if required, switch or adjust any medications that may impact your fertility.

Obesity and Sedentary Lifestyle

Today, most of us have a desk job, which contributes to a sedentary lifestyle. This study reveals that men who have jobs that impose a sedentary lifestyle are more likely to experience testicular overheat, which contributes to a low DNA index.

Obesity, too, is linked with lower sperm quality. Obese men face a higher risk of sperm DNA damage.

Start Working Out 

Exercise regularly. Regular physical activity can help reduce the harm caused by a sedentary lifestyle, lower your body weight, and consequently improve sperm quality. Don’t overdo it, though, as excessive exercising can also be harmful. 

Environmental Exposures

Exposure to environmental pollutants such as harmful toxins found in pesticides, industrial waste, heavy metals, etc., can severely lower sperm health.

Limit Exposure

Avoid exposure to any pollutants or toxins. Avoid plastic containers, use natural cleaning products and pesticides, buy organic produce, and follow proper safety protocol if you work at a job that deals with toxins, radiation, or industrial pollutants.

Aging

The quality and quantity of sperm decreases as men age. When compared to younger males below 35, men over 50 face significantly higher levels of sperm DNA fragmentation.

Sperm Freezing

Males who want to delay having children should proactively undergo a DNA fragmentation test right away. If your fragmentation index is normal now, we suggest freezing your sperm, as your biological clock will keep ticking. It may make achieving fatherhood more difficult in the future.

How To Improve Sperm Quality For Sperm Retrieval

Some fertility specialists will suggest abstaining for a long time before sperm collection. However, the longer the sperm remains in the epididymis, the greater the chances of protein degenerating and increasing DNA fragmentation.

We recommend abstaining for only 1 day before sperm collection to increase the number of mature sperm in your sample. Ideally, ejaculate at the clinic and do not bring a sample from home.

At Corion, our team is dedicated to ensuring the most positive outcome for each of our patients. If you or your partner are facing unexplained infertility, consider asking our fertility specialists about testing for sperm DNA fragmentation.

Frequently Asked Questions:

Q. Is the sperm DNA fragmentation test expensive?
A. While sperm DNA fragmentation testing is more expensive than other sperm sorting techniques, it is very reasonably priced at Corion Fertility Clinic.

Q. Can sperm DNA fragmentation hinder pregnancy?
A. Yes, sperm DNA fragmentation can increase the risk of miscarriage and can even reduce the chances of fertilization.

Q. How do antioxidants treat sperm DNA fragmentation?
A. Antioxidants fight against free radicals, which can harm sperm cells by increasing DNA fragmentation.

Q. Is testing for sperm DNA fragmentation risky?
A. No, there are no risks involved in testing the sperm DNA fragmentation index.