* Author Topic: Sperm DNA Fragmentation – results I think they look bad.....  (Read 2383 times)

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Offline Heidi2

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Hello,
I just got my DH’s sperm DNA Fragmentation test back. It doesn’t look great though as I was told 7 – 10% was normal.  I am struggling to interpret these...and also understand what that means to us....

Fragmentation (%)
Total Sperm                                    N.V.
High Fragmentation 30%           (<15%)
Total Fragmentation 41%          (<30%)


Fragmentation (%)
Motile sperm                                 N.V.
High Fragmentation 28%              (<15%)
Total Fragmentation 36%              (<30%)

The assay result suggest high levels of DNA Fragmentation

Does this mean we are F****D?!?!?!
Thanks guys
H x

Offline agate

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those results aren't that good. 

ideally you'd want fragmentation below 10%.   Once it gets over 15%, studies suggest you have a reduced chance of pregnancy and an increased chance of miscarriage.  Once it gets over 30%, studies suggest that your chance of pregnancy goes down by really quite a lot (maybe like 1/3rd the chance) and your chance of miscarriage goes up a lot.   

When they do ICSI, the embryologist would normally try to select only the best looking and most normally motile sperm (in the hopes that the best looking ones might have less fragmented DNA than the rest of the sample).   In this sample, even when they tested only motile sperm, the fragmentation was still not that good.

However, pregnancies and live births DO happen all the time for couples with high sperm frag - which is why some clinics will tend to suggest there is no reason not to keep trying even with poor fragmentation results.   However, other clinics may be a bit more 'open' about they really think this might reduce your chances and might, for example, say that they think that if you were to use sperm of this quality, your chances might be reduced by by quite a lot, compared to your chances using the same eggs with healthy donor sperm.

Do you think your DH has done everything possible lifestylewise already? (not smoking, taking plenty of antioxidants (vit E, vit C etc), good diet, not drinking?   fragmentation does tend to increase with age, but sometimes lifestyle factors make it worse.

Also, have (you and) your DH tested for all possible STDs like chlamydia, ureaplasma and mycoplasmas?  some docs think that these bugs can lurk for a long time in the testes and contribute to poor sperm DNA fragmentation and it can sometimes be reversed by treating with antibiotics and antioxidants - although it will take at least 3 months to see if it works.

Lastly, if you decide that donor sperm is not acceptable, and the fragmentation can't be fixed, you might want to stick to clinics that do IMSI rather than basic ICSI in the hopes that they are a bit better at selecting the best sperm from a sample.

best of luck

Offline Heidi2

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Thanks Agate for your quick reply,

He got tested for all the bugs when we went to Dr G and they all came back negative...he already takes lots of supplements on his anti-cancer regime but maybe we can tweak these to include higher antioxidants. Do you know what levels of vit E and C are recommended?

He already doesn't smoke or drink. So I'm not sure there is a whole bunch more we can do on the lifestyle factors (although I'm sure there is always room for improvement) ...do you think this result could be because of his prostate cancer?

I'm really stumped as really don't think I would go down DS route - but need time to think it over I guess...
H x

Offline agate

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I honestly don't know what the cause would be or what effect the prostate cancer or any cancer treatment he would have had would have been.

there is info on doses of supplements in the FAQ under Supplements for men

I guess you do need to speak to your clinic to ask how they assess your chances - remember no-one can rule out it working out for you - but I'd be very suspicious if they tell you that it won't make any difference to your chances... its an increased risk of it not working rather than any kind of certainty - because its always possible that the embryologist might get lucky and find a sperm that is tip top (rubbish looking sperm tend to have rubbish DNA, but not all good looking sperm have good DNA).  if you want to keep trying knowing the chance MIGHT be reduced, that should be your choice... but DS shouldn't be discounted.

I guess if you don't want to go down DS route but think you might regret the decision you could decide to freeze some eggs now so you MIGHT have that option if they are good enough when they are defrosted (no guarantees, I guess)... I THINK its better to freeze eggs at 34 than find you've changed your mind at 38?

Offline Heidi2

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Thanks Agate,
I don't know a thing about donor sperm as never imagined I would need it (his count has always been high) so this DNA thing is a real curve ball for me. I understand that donors no longer stay anonymous which has lead to a shortage...do you know are the waiting lists huge? I am due to start down regging in just a week. I'm still not sure I'm ready/happy its a huge leap for me mentally.

I thought you couldn't really freeze eggs very well? As I mentioned this today the idea freezing some encase of a change of heart? (I had same thought as you!)...But Penny at Serum said it would be a waist and that I would be best to fertilize them with DS first then freeze them....but finding a donor for a what if's...probably too much at this stage....

I'm having a hard time weighing up the actual reduction in our stats of success?...I read online today that healthy babies for men with high DFI is fairly uncommon...that sounds a lot worse then just reduced chances....I feel like steaming ahead with our IVF as planned with his sperm but that only gives DH 6weeks to try and improve things ~(not that there is much to change)  - maybe its just wasting a go all together?
H



Offline agate

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re egg freezing: not many clinics do it so far and there isn't much data yet on how successful the defrost and fertilisation bit will be... but its only offered at clinics specialising in vitrification (the freezing tech needed to do it.... and I don't think serum are into it).

re donor sperm: if you are doing it in greece, then its all anon - unless you can make special arrangements to import open ID donor sperm e.g., from ESB in denmark (that is a lot more expensive than using anon donor sperm sourced by serum).  if you are cycling at serum I don't think there will be any problem getting hold of donor sperm there.   if you are cycling in the UK you'd have to ask whether your clinic can get any for you - in the UK, its all open ID.

re reduced chances: well, what I remember reading is that your chance of having a baby would probably go down to something like 1/3rd if DFI was greater than 15%.  so if your basic chance is something like 25%, to reduce that by 2/3rds would mean going down to chances of 8%.... and you'd guess that if its very high fragmentation its going to be worse than that?  but you have to keep remembering that these are only statistical trends - its just possible that you are in the group who would get to bring a baby home regardless of having high DFI.

As you normally get good numbers of eggs recovered, you could also do a split and say, do half with donor and half with own sperm... but then because sperm problems tend to manifest later, the embryos might look pretty similar but have very different capabilities of making a baby - so you'd probably then be doing the strategy of transferring ones from the OS batch and then freezing the DS batch in case you feel ready to use them later, but, then of course, by not using the DS ones fresh you are reducing their chances a bit too... but that's probably still a better option than waiting til you are a few years older and then wishing you had some DS embies in the freezer?

Some clinics (e.g., serum) can do a repeat frag test on the actual sperm sample on EC day- so you can do a last minute swap to DS if the sperm looks poor but can stick with OS if the sperm looks better.  Again, I'm not sure if its serum you are with.

Offline jacky35

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Hi Heidi,


we found out last May after our 4th IVF cycle that DH had 26%DNA frag levels. We also have egg quality issues due to severe endo.


I am 7+2 so very early days yet, after IMSI at the Cube clinic in Prague. Our chances were given at about 15%. There is lots if info about the Cube on the Irish site www.rollercoaster.ie under the fertility issues section.


It is a new clinic and we were told that the embryologist is one of the best in Europe, came from IVF Pilsen.
Costs are 4000euro, which includes IVF/IMSI blast, freezing (if applicable) and EU bloods.


Hope this helps, any other queries just ask

Offline Heidi2

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Thanks Jacky35! And big congtats on your BFP  :) :) how exciting for you -  wishing you well.  ^reiki^

I had been wondering where Cube was...Prague hey!?  Is it hard to get there? What’s the clinic like? I was nervous about treatment abroad but just got back from Serum in Athens where I had a hysto and it was ok. Maybe Prague should be our next stop?

Regarding PICSI and IMSI...do you know if these techniques could be used in conjunction with each other or is it a case of one or other of them?  Also do you have any idea if any UK clinics offer them?...

Sorry loads of questions in quick fire....Agate /Jacky thanks for your posts, FF’s is such a big help when you get dealt unexpected news and drawing on other people knowledge is a great way to make a new plan.
H XX

Offline agate

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picsi is a sort of chemical sperm selection techniqure whereas IMSI is using a high power microscope to try and pick the best sperm.  I guess it ought to be possible to use picsi and then try to select the best of those sperm using a high power microscope - but I GUESS you'd need to talk to the clinics that offer picsi - there will presumably be fewer of them than the ones that can do imsi - as presumably any lab can just buy a high powered 'scope?

I THINK Care manchester do imsi - I haven't heard of anyone in the uk offering picsi yet.  the only clinic I know of for picsi is gennet in czech

Offline Shamrock 2012

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Heidi
I've just sent you a PM. I am doing my next cycle with Cube Clinic in Prague and we are hoping to do a combination of PICSI and IMSI. The consultant there said that they can do PICSI first if the sperm sample on the day of EC is suitable and then do IMSI and then of course ICSI to inject the sperm into the egg.

Hi Jacky35 ..great to see things going so well for you. (This is Babsplease from RollerCosaster)

 

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