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High sperm DNA fragmentation

The results have come back from my husband’s DNA fragmentation test and his level is 30%. That didn’t seem that high to us at first, but the report states that it indicates male infertility and looking online it seems pregnancy is extremely unlikely at this level 😕 We’re already contending with high antisperm antibodies (100%) so this is just another blow - those that do manage to get through by some miracle will likely be damaged. I know we’re doing IVF with ICSI anyway but it just makes me that bit more worried about miscarriage and birth defects if we do manage to get a BFP. My clinic have suggested the TESA method to extract his sperm directly, but this results in lower fertilisation and poorer quality embryos (though higher live birth rates apparently). Lots to think about and don’t feel very positive for our next round. We were already talking to a clinic in Greece for our next steps if this one fails but now I just feel like it might be a lost cause. So much hanging on this next round 🙏

Anyone have any experience with this? Feeling very pessimistic xx

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Sorry to hear your difficult news. My husband also has antibodies although not as high (50% during our 1st ivf and 30% during 2nd). He has never had DNA fragmentation test but our clinic recommends ICSI + IMSI if the % is high. We went for IMSI anyway (2nd IVF) and 13 eggs out of 13 got fertilised and resulted in 8 blastocysts-from top to average quality. Although I didn’t get pregnant with the top quality one and about to start FET, I feel like IMSI was definitely helpful. I really hope that we have one baby amongst our 7 remaining frosties. Maybe this is something you can ask your clinic about. Best wishes xx

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Thanks Kari. That’s great that IMSI was so successful for you, 100% fertilisation is impressive! I wish we could do IMSI but my clinic doesn’t offer it. It’s one of the reasons we were looking at the Greek clinic, if we end up going that route. Wishing you all the best for your FET Xx

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Thank you and I hope you can find a clinic that can help you xx

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Hi hoping-for-th-best. Some causes of DNA fragmentation, if found, cannot be treated, but if the damage is caused by free radicals, then a change in lifestyle and a diet designed to protect against oxidative stress may help reduce the levels of DNA fragmentation in some of these cases. Obviously, as you already protect against free radicals, this does not apply in your case. Treatment of infection, if present, with antibiotics would also be expected to reduce DNA fragmentation. There is some evidence to show that repair of varicose veins in the scrotum (varicocele) repair may improve sperm DNA as they generate excess heat. I have also heard that sperm aspirated from the testicles tend to have a healthier DNA than ejaculated sperm. Studies show that ICSI may be a more effective treatment than IVF for sperm with a high DNA fragmentation. It is always an idea to have a second test performed two months after the first to check for consistency. That’s about all I know about this subject, so hope it helps a little, and I wish you both well with the outcome. Diane

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Thanks Diane, this is very helpful 😊

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Our newest consultant was saying that if you have a good quality egg, then this can overcome issues that there might be with the sperm.

Is hubby using multivitamins?

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Yes he’s been using Condensyl supplements for a while now, which is what they recommend. He doesn’t drink or smoke, his only vice is sweet coffees but he’s making an effort with that now and we both eat well. I think eggs can fix some sperm issues to a certain extent, but where the damage is severe there’s no way they can overcome it unfortunately 😕

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My partner has over 40% fragmentation. My clinic says it is not a problem if you have the correct filtering system when doing ICSI. There is clinic in Cyprus that has new technology. I can PM you the details.

I wouldn’t do TESA or PESA because the clinic can’t filter the fragmented sperm out. That is why our cycle failed (apparently).

Don’t worry. All the doctors I have spoken to say high fragmentation is no issue if you have the right embryologist xx

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Thanks Anna - that sounds really interesting re the new technology, that wouldn’t be IMSI/PICSI would it? I’d be interested to hear about the clinic in Cyprus if you’re able to PM me 😊

I must admit I’ve had doubts about the embryologist technique after our poor fertilisation last time, which was so much worse than previous rounds. It could be bad luck, but I do wonder if they chose the sperm correctly. When you say they can’t filter out the fragmented sperm with PESA/TESA, do you know why that is? Xx

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Will PM you now XX

I think doing joint donor and your own eggs/sperm in one round could really help understand where the issue is and give yourself another go.

The doctor said that with TESA you can’t use sperm selection. He said PESA was more natural and better than TESA. He said frozen sperm from ejaculation is much better than either of these surgeries. Although I didn’t quite understand why...

X

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Hi Anna and Hoping for the best. I’m in a similar situation with the fragmentation but my clinic have recently also started to blame my eggs which was a shock as I’m 33 (with lean pcos). Anna please can you pm me the details of the clinic you’ve used that said fragmentation is not a problem with the right embryologist and also the Cyprus one? It doesn’t feel right for them to suddenly blame my eggs when the previous cycle they said the fragmentation was the problem xx

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I will send you a PM now. Doctors seem to have different opinions and the blame game is so destructive (it also had a big impact on my relationship). Hopefully the my PM will help xx

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I feel for you both hun. I don’t know anything about fragmentation but I wondered if with lifestyle changes it can improve?

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Thanks Leo. Yes, I think lifestyle changes can help some people, if that’s the cause - unfortunately I don’t think it’ll help us as we’ve already been making an effort since before our last round. Having said that, we are going to look into factors such as the length of time he’s sat at a desk, and maybe get a doughnut type cushion for him to sit on, like people use for haemorrhoids 🙊 Hopefully that’ll make a difference.

I appreciate your kind thoughts xx

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I really hope there is something the doctors can do. You just hang in there..

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