After 6 failed ICSI fresh cycles with terrible fertilization rates (0-20%) we finally had a sperm DNA comet test done. It came back showing that my partner has really high DNA fragmentation.
Average: 48% ,
Low: 2%
High: 40%
We consulted with a clinic in Greece and they recommended my partner take high doses of antioxidants.
VIT C = 1000mg and VIT D 400mg as well as daily to every other day ejaculations and keeping it cool down there with loose boxers. He also had a 14 day antibiotic treatment.
The next two ICSI cycles we had 50% fertilization rate and 60% on the last in August which resulted in 3 blastocysts and we got pregnant twice but had 2 early losses.
So massive improvement for us even though we are devastated because of our losses.
We are heading for our 9th ICSI cycle now soon (can’t believe we’ve had that many 🤪) and I just want to reach out to see if anyone has any additional tips on how to improve DNA fragmentation? Would love to hear from someone in similar situation 😘
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Barenina
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My clinic suggested improving lifestyle but ultimately pushed for IMSI rather than ICSI. In IMSI the sperm is first selected with high magnification (trying to guess which is the best guy in the block) before being injected it into the egg. The literature about it is mixed. Mostly it seems not to be so effective, albeit some studies show that in people with high fragmentation may give an edge.
I can see you’ve had a long IVF journey, it must have been really hard!
Can I ask how it went for you with IMSI? I see you had a transfer in December, I really hope it stuck!💫
I am based in Norway and unfortunately there is only ICSI here. We wanted to move to a clinic abroad to get more/better help but because of COVID we ended up buying a 3-pack at the most progressive clinic here in Norway instead.
Can I ask what lifestyle changes your doctor recommended? We got no tips her, only from the Greek clinic we were in contact with…
Did you end up taking DHEA? I saw some of your posts… For me it helped with embryo development on my last ICSI. (I found out I have low testosterone, even though I have high AMH)
Wish you all the best in the world, lots of baby dust 💫
I am currently 8 weeks pregnant with two fraternal twins after a double ET. It is still early days, and everything could change 🤞🤞🤞
To be honest with you, I have no idea whether the IMSI made any difference since we changed a lot of things from previous cycles. I had an endometrial scratch, Neupogen wash and Gonasi injection to prime the endometrium (after being diagnosed with low-activated uNK cell), I took vaginal probiotics for three months and treated my recurrent Candida aggressively (I was suspecting dysbiosis), and massively increased the amount of progesterone (this is actually my new clinic's standard protocol). I do not exclude that I could just have been lucky
I took DHEA, but my results got progressively worse. The first cycle (having taken DHEA only for a few weeks) was the best one. No one tested my testosterone levels, so who knows?
The lifestyle the clinic suggested to my partner was no smoking, no alcohol, a better diet (we are both from the Mediterranean area, so not much to improve here and in general very careful about everything else), and a multivitamin specifically designed for conception (which my partner has been taking for years before the COMET test...). The usual things, so not very helpful.
Fingers crossed for your next cycles, let me know if you have any questions! xxx
Wow congratulations!!! That’s amazing news!☺️🌟🌟 twins, yay! I understand it’s still early days but I wish the very best for you, it sounds like you found out about a lot of things and that your changes made all the difference 💫 (even though I also see that it can be coincidence..)
I have some similarities to you (my partners sperm is def not the only problem 🤪)
1 year ago I got desperate and sent menstrual blood in a jar to a Greek clinic. It came back that I had ureaplasma and dysbiosis. I had an antibiotic treatment but 3 months later I had another test in Norway for NK cells and Infectious Chronic Endometritis (ALICE) and it again came back that I had an infection. So another antibiotics treatment.
The problem is that I’ve been struggling with Candida ever since (without much symptoms just itching)
How did you treat your Candida aggressively?
Did you take your probiotics before transfer or also after? One doctor suggested I take it until 10 weeks pregnant and another just 7 days before transfer. I anyways lost my baby when I took the probiotics but I am still wondering if I should take it before/during my next cycle.
After my two miscarriages this fall I just had a new ALICE test and waiting to see if they infection is still there or finally gone.
Another thing: what kind and how much progesterone are you taking?
I had a FET (for the first time) this autumn and I was spotting before and 3 weeks after my BFP. I tested my progesterone on 15dpo and it was only 6 nml! They told me to double the dose and not test again. It sadly ended in a miscarriage.
Unfortunately I had asked for a new progesterone support for this FET, recommended by a friend who finally got pregnant. It was oral progesterone (duphastone)
My clinic now thinks that this progesterone type didn’t work really well for me and they will test my progesterone levels on the day of my “hopefully” next transfer (fresh) and in addition to cyclogest two times a day give a HCG shot the day after transfer.
Sorry so much info. Our cycles has improved but there are just so many things going wrong and I just need to make sure my progesterone levels, dysbiosis and infection are handled/under control now that 50% of my eggs are finally getting fertilized by my partners sperm 🤪
My IVF consultant and I self-diagnosed together some dysbiosis due to my recurrent candida, so I started taking probiotics 3 months before transfer but not antibiotics (albeit a generic antibiotic is part of my IVF clinic transfer protocol). ALICE and EMMA tests were clear 2 months after having started with the probiotics. No formal testing! I took probiotics only before transfer.
My candida was treated by the NHS Sexual Health clinic (God bless the NHS) that first typed it, and then prescribed me a specific drug that was targeting exactly that strain of candida. That did the trick for now, but they told me it may re-occur or a new strain may become dominant. They said that if you are prone to Candida you will have it for all your life, in a form or another, more often or not.
I am taking utrogestan (oral progesterone), crinone (vaginal) and lentogest (IM). My progesterone was tested the day of ET and with my bHGC after a positive home pregnancy test (2 weeks later). Mine were on a different scale, so not really comparable with yours but in the range of 90-100.
in the past, I was taking Cyclogest (vaginal) and Lubion (subcutaneous), and, at some point, Crinone was also added to the mix (so double vaginal route), with similar reading but no success (if you don't count the first transfer which ended in an early miscarriage, where I was taking only Crinone once a day). I think it is a bit random and depends on who is doing the prescription.
Oral progesterone is the worse for me: it makes me dizzy and sleepy and I must nap at least 1h in the afternoon (or faint).
OMG, there are so many things and many of them are still so unknown even by the specialists that I wonder how we can keep our mental sanity! I spend also a lot of time reading the literature, and, honestly, I still don't know why a threw thousands of pounds (and euro first) for things that are still unproven. Yet, something may have worked this time, so who knows?
Still do not believe it, and looking forward to the reassurance scan next week. I feel it is still too early to celebrate.
Hi! We wanted to go there last year, but ended up continuing with a clinic in Norway because of the unsure situation of Corona. But the clinic I had contact with was Serum IVF.
They seem to specialize in sperm issues and also infections/implantation failure in women. I have heard great things about them and we might consider going there if our next cycle in Norway failes.
I also pushed for IMSI even though the DFI was low but i wanted to pick the best sperm possible. I think it really helped us get 7 blastocysts out of 10 workable eggs.
I’ve seen Impryl being mentioned before, and also proceed max.
But I feel confused. We were told by the Greek clinic to take high levels of antioxidants for my partners DNA damage.
Vit C, E and also taking D and CoQ10 now.
But when I read about Impryl it states this:
Impryl enables your body to provide all the natural antioxidant support you need.
We strongly discourage taking Impryl alongside strong direct antioxidants such as vitamin C, CoQ10, selenium and so on. These substances may induce ‘reductive stress’ that may negate the benefit of Impryl. Strong antioxidants have been shown to cause an increase of the sperm decondensation index (SDI), which is very bad for male fertility.
So from that info, what my husband is taking is actually bad for his sperm? At least we have gone from a 0-20% fertilization to a 50-60% fertilization rate. The Greek clinic is quite knows for its sperm improvement protocol.
But I know you guys have Johnathan Ramsay etc which are really good/updated on the area as well, so not sure who we should listen to 😅
You did nothing else than taking vitamin D and Impryl?
We finally got pregnant this fall but sadly had two miscarriages. Not sure if it’s because of dna damaged sperm, eggs or something else.
I felt exactly the same, supplements: so confusing. Yes, so we did one cycle with Proxeed, ubiquinol 200-300mg, vitamin D and 1000mg omega 3, and one with Impryl, vitamin D and Omega 3 only. My partner didn't take antioxidants with Impryl as I'd read the same as you.
We got better results with the Impryl combo, but other factors could have influenced these results for all we know.Go with your gut feeling. I've heard some people even alternate proxeed and Impryl🤪.
We are in a similar situation, except that we've never got to implantation.
We just didn't know whether to put two in, test immunology or test PGTA. We ended up doing the latter.
It's expensive, but I figured at least we'll know if the issue is quality or if it's me and we need to look at ERA, NK cells etc.
I really feel your frustration. My clinic tells me it's a numbers game, but ruling things out seems a better approach to repeating the same approach.
I'm sorry to hear about your miscarriage, that's really tough. All the best with your next moves. With some determination, we'll very hopefully get there!
Do you know the cause of the fragmentation? Is it a varicocele or an infection? I would recommend a urologist before doing anymore cycles to fix the root of the issue first xx
I pushed my partner to go to a Urologist last may, but not much came out of it. Just a lot of money 🤪
She said she saw a small varicocele, but they anyways don’t operate on men after the age of 30…as there is no point.. ?? (Thought that was strange! I give up on Norway!!!)
She did not even check for infection, just a lot of cancer related things even though she was listed as a fertility expert…
We’ve both had Ureaplasma 5 years ago but he has been twice on antibiotics, last one was one year ago. And he’s taken samples at the gynecologist which showed nothing.
So we don’t really know why he has the DNA damage. I suspect because he has quite small testicles, and low sperm count. Maybe it just gets too hot down there?
I’ve read the operation often doesn’t give any better results. But we would def be up for it if they would operate on him. But they said he was too old at 40 years old. I guess we could have a second opinion, but time is running out for me as well as I am 39 and with poor egg quality 😅
I just wish we had found out about this way sooner. I kept suggesting the DNA test but the doctors at my previous clinic just laughed.
I see you got your baby, congratulations!!!🌟😍
Did you do anything else than the operation?
We also have a child from our second ICSI. So so so grateful! But now we’ve spent 4 years trying for another and I am going crazy.
Please try and enjoy the time with your baby and not think too much of a second if you can. I am so glad for the 1 year I had a total break from it all and just enjoyed my baby boy 💙But I can see time is also not on your side, so I totally understand you.
Wishing you all the best, and enjoy your little one to the max!
Wow what a warrior you are. My partner had 52% DNA fragmentation - the cause was considered to be a large varicoele and some damage done to his veins during some childhood surgery - heating up the area. He couldn’t have varicoele surgery due to earlier damage but it can improve results for some men - the repair can take up to 6-12 months for benefits to be seen.
So without that as an option we focused on the things you mention. No hot baths, loose boxers, cut down on cycling, cut out alcohol and processed food, took supplements (proxeed or proceive max + lycopene), and an infection screen also picked up ureaplasma and gardenella so he had antibiotics.
We had our first round last May, but we did know the issue was him so we spent time with male fertility experts (including Ramsey) before that.
Out of 14 eggs we made 1 blastocyst with IMSI, he’s kicking away and will be joining us in a few weeks. I was prepared for it to never work for us but we found one sperm. We’ll never know whether it was luck that they picked a good sperm or something we did but I hope you find the answer you are looking for. xx
What a story, congrats on your pregnancy!🥳🌟 one out of 14, wow!🌟
So you already knew your partner had DNA Damage before you even started on your IVF route, good on you!
We had to go through 6 failed ICSI attempts and no one even suggested it and I googled “low fertilization rates ICSI” over and over again but I just could not find the info about DNA fragmentation before years in! Apparently it does not often lead to fertilization problems 🤷🏻♀️
But we are so lucky to have a son from our second ICSI attempt 6 years ago. An embryo divided three times transferred at day two. Our miracle!💙
Ok, so I just went into Amazon and ordered proxeed max for men 👌 He will be so happy for some more vitamins to take 😅😂
Interesting that your hubby had ureaplasma. We both had it 6 years ago but I can’t seem to get rid of it. It does now show on a vaginal swab anymore but I’ve had a endometri-test showing elevated plasma cells = infection up there. Done lots of antibiotic treatment. just had another biopsy today and get the results back in a few weeks. It can also cause trouble with implantation failure ++ so best to get rid of it!
(There seem to be no end to what’s wrong with us 🤪)
Did you ever check and have an antibiotic treatment?
Good luck with your pregnancy, so happy to hear it’s possible with high dna damage 😎💫
Then we both have little miracles despite the sperm challenges!
I wasn’t tested for ureaplasma but we were both treated. I have had recurrent BV in the past so as well as antibiotics I used canesbalance to treat that. My husbands problems were identified with a normal sperm analysis and I really wanted to help him find out why so I think seeing a urologist was the right first move for us (I was secretly hoping we could avoid IVF). He had such low count and motility and morphology - but it was amazing to see the count and motility improve vastly with diet and lifestyle. When morphology hadn’t improved we did a DNA fragmentation test and an ultrasound showed inguinal hernias as well as the varicoele. So while we couldn’t fix everything it really helped my husband deal with the numbers and throw everything at the lifestyle changes.
Just remember you just need to find one! That’s all it took for you last time. xx
You are right, it only takes one! But it also needs to be matched with a good egg and that everything is top at my end regarding implantation etc 💫
So happy for my miracle boy every day 🌟 just greedy and want more!🥰😅
Can I ask how long you were taking the canesbalance? After all my antibiotic treatments I’ve had problems with the environment down there. One doctor suggested I should take vaginal probiotics until
10 weeks pregnant and another just 7 days before transfer. Not sure what to do on my next cycle…
All the best to you and the little one growing inside 💫
Yeah antibiotics give me terrible thrush every time. It was Canesflor in fact - and I think i took for just over a week. I had finished by the time I started my cycle. x
Yeah but I am based in Norway and they only have ICSI here 😕 maybe I should write my clinic and push them to get more progressive!
They do have TESE here where they remove the sperm surgically.
We did 50% TESE and 50% ICSI on our try last year. Strangely it was ICSI that worked a bit better regarding fertilization. But all the embryos except one arrested after fertilization on that round and I again only had one embryo to transfer on day two. = BFN.
After that I found out I had low testosterone and I added DHEA for four months. On our previous cycle after adding DHEA is when I got pregnant twice.
So maybe TESE would work better now my egg quality is better?
It’s hard when we both got problems = a disaster 😅
We had my husband take anti oxidants called menevit for 3 months and also got him to cut out any inflammation in his diet so no gluten dairy or sugar or caffeine or alcohol! It was hard but worked for us we got 9 blasts from 13 eggs and our second FET worked I’m holding him now! Good luck x
Congrats with your baby! I am myself trying to cut way down on sugar, dairy and caffeine but it’s harder to get my partner onboard 😅
I guess all these years or trying has also become such a pain in our lives that we just want to start living again and drinking and eating what we want and just enjoy life!
But this might be our last try (at least we tell ourselves that) so we should try to cut down on all the things you are mentioning!
Do you think it helps to cut down or do you have to cut it 100% out to be affective?
I can’t believe people just have babies by having sex and not worrying about any of this stuff 😂
Hey, I'm going to be boring here and say lifestyle & diet changes are key. Sperm are affected by a number of modifiable factors which is good news! There's plenty you can do to turn sperm parameters around <3
Things I would look at
Trans fats - things like crisps, chips, packages foods etc
Toxic exposures
Being sedentary
Lack of sleep
Low testosterone
Testicular heat & exposure to electromagnetic radiation
Insulin resistance
Things I would focus on
A wholesome diet - the Meditteranean diet is good & easy to follow
Lots of movement - even daily walks
Cod Liver Oil - Raw & unheated
Vitamin C - whole acerola cherries are a good option
I have myself been taking baby steps in the direction of a Mediterranean diet but undertake I should probably include my partner more!
He is actually taking HCG shots so raise testosterone and get a higher sperm count. From what we can see he is at least becoming quite buff 💪 and enjoying that 😎
I will look at the rest as well and try to see what we can manage 💫👌
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