What Are the Indications for Sperm-DNA-Double-Strand Fragmentation Testing?
Sperm DNA fragmentation refers to the presence of breaks or damage in the sperm DNA strands. A high level of fragmentation can affect fertilization ability and embryo development, making it a key factor in evaluating semen quality.
The sperm fragmentation test cannot be detected through a standard semen analysis and requires a more in-depth study of the sample.
It is recommended in the following cases:
- Advanced male age.
- Infertility of unknown origin.
- Repeated failures in assisted reproduction techniques.
- History of recurrent miscarriages.
- Retrieval of low-quality embryos after an IVF/ICSI cycle.
- Patients with chronic illnesses, such as diabetes.
- Exposure to known risk factors, such as smoking, excessive alcohol consumption, exposure to environmental toxins, or oxidative stress.
- Patients with varicocele.
How Is Sperm DNA Fragmentation Testing Performed?
There are several methods for assessing sperm DNA integrity:
- TUNEL (Terminal de Transferase dUTP Nick End Labelling): It detects breaks using labeled nucleotide information.
- SCSA (Sperm Chromatin Structure Assay): It uses flow cytometry to identify damaged areas.
- SCD (Sperm Chromatin Dispersion): It analyzes the sperm’s dispersion capacity through microscopy.
- COMET Assay: An advanced technique that allows precise detection and quantification of DNA damage.
What Does a High Level of Fragmentation Mean?
Fragmentation is directly related to semen quality, meaning that a high fragmentation result indicates damage to the sperm’s genetic material and, therefore, low quality. It is associated with reduced natural fertility and decreased success rates in assisted reproduction treatments.
What Treatments or Solutions Are There to Reduce Sperm DNA Fragmentation?
- Lifestyle Changes: Following a healthy diet, reducing stress, and avoiding harmful habits such as smoking and alcohol consumption.
- Antioxidant Supplementation (such as vitamins C and E or coenzyme Q10) which helps reduce oxidative stress.
- Treatment of Related Conditions such as infections, inflammatory processes, or surgical repair of varicocele, if present.
- Use of Assisted Reproduction Techniques such as ICSI and IMSI, which select sperm before the process.