Sperm DNA damage provides powerful insights to male fertility

By Prof. Sheena Lewis, CEO, Examen


You may be surprised – or possibly reassured – to learn that more than a quarter of couples having fertility investigations are told that neither of them has any detectable problems[1], or maybe you are disappointed. We are too. This is frustrating for both the fertility expert and the couples trying desperately to have a baby. Which pathway will take them a step in the right direction? How do they know where to start? Tackling infertility effectively can only really begin if we understand the main causes.

Sperm quality over quantity

In 2018, the UK Human Fertilization and Embryology Authority reported that male problems were the most common reason for having fertility treatment[2] so men should be checked out very carefully. What’s astounding is that when male fertility is finally looked at, (this is always secondary to female investigations) the focus is on semen analysis, and sperm quantity over quality! And when men have a normal semen analysis, they are highly unlikely to be investigated any further. With seemingly no obvious cause for their fertility problems, the male fertility investigation stops right there, and attention is directed back to the woman.

A vital yet missing component of the standard fertility investigational process in couples is sperm health. Research has shown that 20-40 % of men with ‘unexplained’ infertility have high DNA damage (or fragmentation) in their sperm[3],[4], and this has been shown to have strong links with miscarriage as well as the likelihood of Assisted Reproductive Treatment (ART) success[5].

The quality of sperm DNA is vital as it carries a copy of the genes that a man passes on to their baby. Not only do these genes pass on characteristics like eye colour or height, but they build our brains and determine our behaviour and future health.

Here are answers to a few questions we are frequently asked, to help all men and their partners reading our post:

Why test sperm DNA?

While sperm DNA damage is a leading cause of male infertility, it is not tested routinely in most clinics. Even though you can have a normal semen analysis, your sperm DNA damage could be high. That makes it less likely that you would get your partner pregnant naturally, or even with treatment[6]. Men with high levels of damaged sperm DNA also have double the risk of miscarriage[7].

Not only is sperm DNA part of your baby’s blueprint, but the quality of your sperm DNA will help fertility experts predict the fertility treatment with the highest likelihood of success for you. This means that you could potentially improve your chances of getting pregnant with fewer treatment cycles.

Lifestyle changes and clinical interventions can improve sperm DNA damage.  Measuring and understanding levels of sperm DNA fragmentation is so important to help more men become dads.  Some sperm DNA damage happens when sperm are being made; by snapping some of the DNA strands. This can’t be prevented, but men do have the power to reduce the DNA damage caused by lifestyle hazards like smoking or being overweight. With the right understanding and advice, men can protect and improve their sperm health.

Where can you get tested?

Examen’s Exact sperm DNA tests, based on over 25 years of fertility research, measure the level of DNA damage in sperm (test results within just 10 days). A test will give you and your fertility expert a better understanding of your sperm quality and the best course of treatment for you.

Exact tests are available in most fertility clinics in the UK, and we are pleased to be expanding access in Europe. ExSeed Health, Examen and Skive fertility clinic in Denmark are in collaboration in a research project to measure improvements in poor sperm quality with life-style interventions.

Get your sperm in the best possible shape

Once you get a diagnosis (analysis of sperm parameters and DNA) you can take back control. Even if you do have high levels of sperm DNA fragmentation, it is possible to reduce sperm DNA damage with lifestyle changes, and increase the likelihood of getting pregnant both naturally or with fertility treatment such as IVF or ICSI. For easy ways to improve sperm health, have a look at our lifestyle blog article.

Don’t delay analysing levels of sperm DNA damage  

Powered by Examen’s proprietary SpermComet® technology, the Exact® range of sperm DNA diagnostic tests provide essential information for fertility specialists to help them diagnose male infertility and make the best treatment decisions for their patients.

Speak to Examen’s fertility expert about Exact Sperm DNA Tests and map out the pathway which is most appropriate for your individual circumstance.

Examen’s team in the UK is delighted to bring Exact tests to Denmark, thanks to Professor Peter Humaidan.

References / further reading:

[1] https://www.nhs.uk/conditions/infertility/causes/

[2] https://www.hfea.gov.uk/media/3188/hfea-fertility-trends-and-figures-2014-2016.pdf

[3] M. Bungum, P. Humaidan, A. Axmon, M. Spano, L. Bungum, J. Erenpreiss, A. Giwercman, Sperm DNA integrity assessment in prediction of assisted reproduction technology outcome, Human Reproduction, Volume 22, Issue 1, Jan 2007, Pages 174–179, https://doi.org/10.1093/humrep/del326

[4] Nicopoullos J, Vicens-Morton A, Lewis SEM, et al. 2019. Novel use of COMET parameters of sperm DNA damage may increase its utility to diagnose male infertility and predict live births following both IVF and ICSI. Hum Reprod. 34(10), pp.1915-1923. doi:10.1093/humrep/dez151

[5] Simon L, Proutski I, Stevenson M, et al. 2013. Sperm DNA damage has a negative association with live-birth rates after IVF. Reprod Biomed Online. 26(1), pp.68-78. doi:10.1016/j.rbmo.2012.09.019

[6] Lewis, S.E., Aitken, R.J., Conner, S.J., De Iuliis, G., Evenson, D.P., Henkel, R., Giwercman, A. and Gharagozloo, P., 2013. The impact of sperm DNA damage in assisted conception and beyond: recent advances in diagnosis and treatment. Reproductive biomedicine online27(4), pp.325-337.

[7] Robinson, L., Gallos, I.D., Conner, S.J., Rajkhowa, M., Miller, D., Lewis, S., Kirkman-Brown, J. and Coomarasamy, A., 2012. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Human reproduction. 27(10), pp.2908-2917.

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