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Sperm DFI Test

SPERM DNA FRAGMENTATION TEST

Fertilization and subsequent embryo development depend in part on the inherent integrity of sperm DNA. Sperm DNA is bound to protamine and is naturally present in a compact state, protecting it from damage during transport. Some damage can occur, which can be repaired in the cytoplasm of the oocyte. When the damage exceeds the cytoplasm’s repair threshold, however, infertility can ensue. 

A conventional semen analysis done for sperm concentration, motility analysis and morphology assessment cannot assess the sperm at the molecular level and as result aid the detection of DNA fragmentation.

What are the effects of high sperm DNA fragmentation?

  • Affects blastocyst development
  • Higher the chances of failed assisted conception treatment and miscarriage
  • Higher in subfertile men with abnormal sperm parameters
  • Also seen in men with normal sperm parameters

What are the causes of Sperm DNA Fragmentation?

The aetiology of SDF is multifactorial. Its accurate clinical implication remains poorly understood. Currently, there seems to be insufficient evidence to support the routine use of SDF in male factor evaluation. This test offers a possible further explanation for un-explained infertility. The results of a sperm DNA damage test may impact slightly on the management of your treatment but may identify why you are struggling to get pregnant.

In men, the major contributing factor for sperm DNA fragmentation is oxidative stress, which can be associated with one or more of the following:

  • Infection
  • Fever
  • Elevated testicular temperature
  • Recreational drugs
  • Smoking
  • Alcohol
  • Stress
  • Diet
  • Environmental and occupational pollutants
  • Advanced age (>40 years)
  • Varicocele

What are the advantages of the sperm DNA fragmentation test?

  • Provides a reliable analysis of sperm DNA integrity that may help to identify men who are at risk of subfertility
  • Provides information that helps in the clinical diagnosis, management and treatment of male fertility
  • Provides prognostic value in assessing the outcome of assisted conception treatment
  • DFI testing may help better select varicocelectomy candidates among men with borderline or normal semen analysis parameters.
  • It may also provide possible explanation in couples with unexplained infertility or recurrent pregnancy loss or IUI failures.
  • DFI may provide prognostic information in couples that have previously failed IVF/ICSI.
  • Additionally, high DFI may be a reason to consider using testicular sperm rather than ejaculated sperm with IVF/ICSI.

High rates of sperm DNA fragmentation and pregnancy potential

  • Normal, healthy pregnancies do occur in couples where the male partner has high percentage of sperm with fragmented DNA, although the chances are significantly reduced.
  • Embryos derived from sperm with highly fragmented DNA have poor prognosis
  • DNA fragmentation could result in initiation of apoptosis and mutations resulting in blastocyst arrest, miscarriage and abnormalities in the offspring.
  • Sperms with high DNA fragmentation fertilising younger oocytes than older oocytes carry a better prognosis of successful pregnancy, as they are much more efficient at DNA repair of defective sperm

What are the indications for men who may benefit from doing sperm DFI test?

  • Unexplained infertility
  • Arrested embryo development
  • Poor blastocyst development
  • Multiple failed IVF/ICSI treatments
  • Recurrent miscarriage
  • Advanced chronological age (>40 years)
  • Varicocele
  • Poor semen parameters
  • Exposure to harmful substances

How is sperm DNA tested?

Sperm DNA fragmentation is tested by different techniques. The mostly commonly used SDF tests include comet assay, sperm chromatin structure assay (SCSA), sperm chromatin dispersion (SCD) test (or halo assay) and terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate-nick end labeling (TUNEL) assay

A sperm sample is collected, analysed using Sperm chromatin Dispersion (SCD) testing technique, where the sperms undergo acid denaturation, removal of nuclear protein content, followed by different staining process and fixation. SCD test is based on the principle that sperm with fragmented DNA fail to produce the characteristic halo of dispersed DNA loops that is observed in sperm with non? fragmented DNA. The amount of DNA damage is calculated using DFI (DNA FRAGMENTION INDEX). A DFI of 20% or more significantly reduces the success rates after ICSI.

Sperm that have been tested for their DNA integrity cannot then be used for treatment, they are destroyed by the test.

What is the treatment of high sperm DNA fragmentation?

It depends essentially on the cause. If the damage is caused by free radicals, a change in lifestyle and diet designed to protect against oxidative stress may help reduce the levels of DNA fragmentation. Other treatment options include:

  • Antibiotics in the co-existence of an infection
  • Life style changes – Avoid drugs, smoking and occupation
  • Diet – Eat fresh foods, particularly those containing antioxidants and vitamin C & E
  • Varicocele surgery
  • Testicular aspiration of sperm (DNA damage occurs at the post-testicular level, hence testicular sperm may have a better DNA integrity than ejaculated sperm)
  • ICSI rather than IVF

 

Initiatives to reduce the levels of fragmentation can be assessed by undertaking a second test three months later.

Medicinal antioxidant treatments have not been shown to be effective so far, but this is one area of research that is continuing.

SUMMARY:

Despite suggestions that sperm DNA fragmentation could be a marker of sperm quality and predictor of fertility treatment outcome, this has not generally been supported by the evidence so far. 

It cannot be regarded as part of the routine semen assessment at the current time.

Sperm DNA fragmentation may vary considerably over time in a single individual.

The best way to reduce sperm DNA fragmentation is to eat fresh foods, particularly those containing antioxidants or vitamin C and E, and to stop smoking.

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Testimonials
Testimonials

What Our Client Say

We love that our patients feel inspired to write about the care they received here at Vishvas Fertility! Here are some of the wonderful letters and comments we have recently received.

pramod kr
pramod kr
2023-11-07
We visited Dr. Basavaraj for our treatment. We had to visit for over an year and couple of procedures. Doctor is very knowledgeable and has vast experience. Nurses and other lab staff are good. Initially the wait time was less ,however off kate the wait time is on higher side since doctor does scan and procedures in parallel. The wait time doesn't change even with prior appointment . This is especially true in Marathahalli centre. This can be improved. I feel cost here for treatment is much lesser than any corporate hospitals or other centres. Doctor is mostly straight forward and not verbose. Also doctor prescribes just enough medication which might or might not be good, hard to judge.
Rajeev Kothamachu
Rajeev Kothamachu
2020-11-12
I highly recommend the doctor if there any complications. I visited him and we got very good results. He has very good patience and listen all the problems. Doc is not that commercial he is collecting the same from last 4 years. We are now visiting him again for 2nd pregnancy..
Divya Sharma
Divya Sharma
2020-09-08
Dr Basavaraj is amazing and genuine person. Report asked by him are only needed one, no additional like many other place. All clinic staff are even good n helpful, Appointment recommended Over all very good Dr for fertility.
Vinay K
Vinay K
2019-05-16
Very good doctor , provides good information about the procedures ,
Abhijit Sarkar
Abhijit Sarkar
2019-05-14
We worship God and many says that Doctors are possibly the one. We (me and my wife) evident that in our difficult time. Thank you Dr. Basavraj for your treatment and care. You will always be there in our heart and any word of gratitude is not enough. We have blessed with a baby boy and he is doing great. we were struggling from almost 3 years and finally we have been blessed. We (me and my wife) can never forgot what you did for us. When in difficult time people goes away, you have been our hope and belief. we were really very lucky enough that we got a chance to meet you in person and got the treatment. Our Best wishes to you Doctor and may you help many more people who are suffering from fertility issues. We were really amazed that even after such a busy schedule doctor finds the time to respond whenever it was required (in panic situations). Thank you once again doctor for your personal attention. Our best wishes for you and your family. We will surely come and meet you very soon, I am sure my son also will be blessed by just seeing you. You have given us the reason to Smile 🙂
Bharath Konegadde
Bharath Konegadde
2019-05-06
Dr Basavaraj Shetty take care and advice till 3 months pregnancy . One of the best doctor in hsr
Dr Chetan Kumar N.G
Dr Chetan Kumar N.G
2019-04-16
Dr Devarshetty has a midas touch in his treatment apart from his knowledge skills as a infertility specialist. I recommend all patients to be open minded while consulting him. My wife had a very difficult phase in conceiving after getting ectopic pregnancy twice in 2015-16 because of her PCOD . Being a Dr myself i couldn't cope up with the stress with which i and my wife underwent during those times,later in 2016-17 after Dr Devarshetty advise and treatment we finally became parents and it was the most joyous moment of our married life. Now we have a healthy baby girl 10m old..posted mother and baby image.

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