Sperm DNA fragmentation 30%

[ParkayFloor]

After three early losses myself and DH were tested and is sperm DNA fragmentation has come back at 30%

I can't speak to a consultant for a week and I'm terrified. I feel sick that I may be pregnant now and may have another miscarriage. I'm so so scared. Can anyone share any information at all? How bad is 30%

Pretty bad. How old are you both?

How is dh's diet? A super healthy diet + supplements can help (obv no smoking or drinking).

Sometimes couples go for ivf with icsi or even donor sperm or egg.

He's very healthy generally. I'm angry with the consultant because she called him and told him it was fine and just to take supplements and he doesn't seem to realise how serious it is. I'm in bits.

He's already on supplements isn't a big drinker at all and exercises a lot. I feel so hopeless. Does this mean we will never achieve a sustainable pregnancy?

I'm 33 and he's 35

It's a bit of a shock to hear but it's good he's having supplements. Are they either Profertil or Proxeed? Those are best balanced and better than individual bits. I'd also recommend pomegranate juice and 8-10 of his 5 a day.

Is the consultant a urologist specialising in male fertility? Or a female fertility doctor? A lot of female fertility doctors barely acknowledge male problems and treat the woman...

Has he been on the supplements for at least 3 months before the analysis? If not, then I'd carry on with them and test again. It might just be better.

Thanks for replying I'm in complete shock. He has said before he wouldn't entertain the idea of a speak donor but I'm wondering if that's a conversation we need to have again. It's a female fertility doctor and she seems to play everything down it's infuriating.

Can anyone recommend a specialist in this area? We are in London.

Could you ask to be referred to someone who specialises in male infertility?

It was a private clinic we went to I have just emailed Dr Jonathan Ramsay who is a urologist specialising in male fertility- hopefully he can help.

Dr Ramsay is the most famous in the business but there are other Ines too.

I wouldn't worry about a sperm donor just yet - it's extremely sensitive. Try the doc and supplements etc. And also there are things such as icsi, imsi etc which might help with sperm selection. Luckily you're young so should get a good batch of quality eggs with a good clinic.

Hi @ParkayFloor,

I've just failed first cycle of ICSI after getting lots of eggs but no good quality embryos. Consultant advised us to check the sperm dna as if it's high they will extract sperm directly from the testes (fragmentation apparently happens after the testes) and use this instead next time as it may help.

Dna fragmentation has come back moderately high at 20% - seeing consultant tomorrow to discuss if this means surgical soerm retrieval next cycle with ICSI so I'll let you know how I get on!

I Read 30% is high but have only read of levels a lot higher being recommended for donor sperm x

Hi @hoping2018 sorry to hear about your failed cycle.

What did you get advised at your appointment today? My clinic says that anything 24% or below is OK.

We have an appointment with a specialist urologist but it's not until May so until then DH is going to be implementing the lifestyle changes and hopefully we will be able to bring the fragmentation down that way.

Hi @ParkayFloor ,

So we're having ICSI because of male reasons but when we got 14 fertilised embryos last cycle we thought we were sorted! only to then have no good quality blasts at day 5 so there is an obvious quality problem with the sperm or egg.

Although we had quite a few (5 out of 14) cleavage which may have been egg problem the majority of embryos died off between day 3-5 is most likely a sperm problem. so the consultant was most suspicious of sperm still being the problem.

So we're booked for another cycle with slightly lower doses of menopur for me as I was overstimulated and they will take sperm directly from the testicles to overcome the dna fragmentation. Also went through all supplements with us and put me on co q10, melatonin, DHEA, more vitamin d etc and checked my husbands Wellman. He takes and we just picked up some omega 3 for him in addition to the prostace Wellman.

We will be rattling!

Sadly he did end the session briefly mentioning donor conception but said that was still some way offf (he normally suggests at least 3 cycles with own genetics at our age)

Sounds like our situations are quite different as we can't even get to a positive test but I would have thought that if your DH dna fragmentation doesn't improve with supplements then ICSI may help and maybe even ICSI with surgical sperm retrieval. I'm sure they'd try those things prior to donor xx

Hi @hoping2018 thank you for the update. It's all so unknown isn't it. I really hope the next try for you is a successful one I'll be looking out for updates from you and crossing everything!

@hoping2018 do you have other male factor issues aside from the 20% fragmentation? My clinic puts 20% in the acceptable range.

Yes we have discovered this problem through tests for repeated miscarriage. We are trying the supplements but how much can you realistically reduce DNA fragmentation by?

Yeah we had reduced everything when first tested though DH the made lifestyle changes and actually the sperm that was used when we did ICSI was ok in pretty much everything.

We've only that the DNA fragmentation tested for the first time a few weeks ago so god knows what it was when we started TTC! though DH is healthy, normal BMI, non smoker etc so not had huge changes to make.

I'll let you know how I get on -EC isn't til first week in May though x

Hello ladies,

Hope you're all doing well. I was wondering if you had any success improving the sperm DNA fragmentation and how you went about it?

We recently found out DH sperm has a high level DNA fragmentation of 37%. It took us by surprise as for years we thought he only had an issue with low motility. We got referred for IVF/ICSI and had one cycle in 2015 resulting in 1 egg but unfortunately the cycle failed. We started the ball rolling to try IVF with ICSI again but now as mentioned the above issue was raised.

Did any of you manage to see Mr Ramsey and how much did the whole process and treatment cost? I recently got quote from his clinic that the initial consultation and follow ups cost £280 each time! We've already spent over £1,000 for a consultation, scan for me, and multiple semen analysis and DNA fragmentation tests for DH privately overseas (excluding flight & accommodation). And most recently we visited another fertility clinic (second opinion), this time in London which cost us £485 for initial consultation, AMH blood test and ultrasound. The follow up will cost another £200.

I am so upset that we're going to have spend even more now to investigate DH male fertility factor and wondered if it's really worth it before having another cycle of IVF/ICSI?

Thank you x

Hi,

Just to let you know after my husbands borderline sperm dna fragmentation we had surgical removal of sperm for cycle 2. We still had some quality issues (22 eggs, 13 fertilised, only 4 in the running on day 3) however had 2 put back in on day 3 - and I’m currently one day overdue with one baby. The final two embryos are now frozen. This was a massive improvement on our first round of ivf where on day 5 we did not have any good quality embryos (despite similar egg numbers and fertilised embryos)

So for us we didn’t investigate reasons for fragmentation at all, just went straight to surgical retrieval of sperm and it seemed to make all the difference.

Good luck

@hoping2018 Thank you so much for responding. Congratulations on your full pregnancy.

I didn't realise surgical sperm removal was used for DNA fragmentation cases. I assumed it's only for low sperm quantity. I have low ovarian reserve so I doubt I'd get many follicles collected. I responded quite poorly to stimulation on my first IVF. Only 3 follicles were at 18mm and the surgeon was only able to collect 1 egg! The cycle was doomed from the start.

I'm due to have an AFC scan on 18th Feb to see how many follicles i have. I can't imagine having more than 8 in total .

Hi OP,

DH had fragmentation of 26% when we had recurrent miscarriage tests, so only a wee bit lower. Clinic didn't think we required treatment and DH only took the Pregnacare male supplement. We have 1 DD now, naturally conceived.

I know this isn't great news for you but I also don't think it's anowhere close to a disaster. Best of luck for the future.

@badgergirl123 glad to hear you finally had a successful pregnancy. In nearly 6 years of TTC I've not fallen preganant once...

Sorry to hear that Maybe 😕 All the best for the future.

Hi there

I just wanted to add my experience to this discussion as it may help.
My husband and I have had 3 rounds of icsi due to male infertility (low morphology, count, motility - everything was low) , luckily we have one 3 year DS (from icsi) but have been through 3 miscarriages having the FET’s.
Anyways after the last mc the fertility clinic could offer no help, i had thrombo panel taken (32 vials of blood taken for this one) NK cells looked at, thyroid bloods taken all came back negative, we were at a complete loss as to what to do next.
I decided to see an excellent fertility nutritionist based in London called Melanie Brown. She actually suggested my husband have a sperm dna test (something our clinic NEVER suggested) and for us to both take supps and diet change.
He was recommended the best urologist dr Jonathan Ramsay in London and went along to see him.
Turns out his DNA result was terrible 70% of his sperm was fragmented (alongside the low motility, morphology etc) dr Ramsay actually said it was nothing short of a miracle we managed to get pregnant via icsi and have our son.
Long story short my husband saw him for a period of 6 months and spent around £4K (not cheap I know) and he endorsed everything Melanie brown recommended for him which was:
Fertilix max supplements
MOR smart fats EPA
Vitamin D spray
Along with a huge diet charge of eating:
Watercress (the best food a guy can eat apparently in order to change the amount of free radicals in their system)
Mushrooms
Walnuts etc
He also told my husband when we go back for another round of icsi rather than waiting the usual 3 days before ejaculation at the clinic, do it 18 hours before you go to the clinic and then obvs once you get to the clinic. The logic behind this that the less time the sperm sits in the body the less chance it has to be exposed to free radicals in the body that will damage the sperm.
Anyways, we got 18 eggs, 10 fertilised & 4 made it to 5 day blast. 3 were 5aaa grade embys and the other was one grade below (can’t remember exactly). We had two transferred (always done this in the past and only ever one stuck before it ended in mc around 8 weeks three times - apart from my son). This time I’m happy to say I’m 12 weeks pregnant with twins, had my 3 month scan today :)
I just want to put this out there in case anyone will find this info useful :)

@badgergirl123 Thank you.

@primrosehill82 Hi. Thank you for weighing in. Congratulations with your pregnancy, such amazing outcome.
How long did you have to wait (while your husband was being treated by Mr Ramsay) before going for your most recent IVF? I'm trying to work out how long it will take for my DH to be treated by the Urologist before we commence IVF/ICSI. We initially agreed to do IVF in March but obviously that's not going to happen now as he needs to see Mr Ramsay first. And you're right about him not being cheap! We don't have £4k to spare on a Urologist. The initial consultation and tests has already cost us £1230!!!
I had a look at the Fertilix Max supplement, that's not cheap either. Was your husband prescribed any medication or did he just go down the supplements and nutrition route to improve his sperm DNA fragmentation level?

Hi @Maybe2019

My husband started seeing dr Ramsay in feb last year, dr Ramsay stated he wanted to see him ongoing for 4 - 6 months. (After the initial consult you can do follow ups via Skype for around £100 with him). The purpose of this was to continually check his semen results whilst the diet change was in effect and also to see how the supplements were performing. Also he had my husband do a sort of ‘trial & error’ on sperm samples. For example he would have him abstain for 3 days then go and see him to give a sample, then next time abstain for one day then give a sample etc. Hence he came to the conclusion that my husband had the most optimal sperm if he ejaculated 18 hours before he then ejaculated again for icsi.
Nope He was not prescribed anything else other than:
Fertilix max
MOR smart fats EPA
Vitamin D mouth spray.
You can actually google ‘Melanie brown sperm & egg salad’ and get the recipe there, we were eating this pretty much every day (amongst other stuff) it’s not too bad.
We started ivf in November just gone, so we were doing the diet and supplements till then really.
Incidentally I was on supplements too, I’m not sure if you want a list of what I was on?! I’m more than happy to give it to you. I don’t have any fertility issues personally but I was on supps to increase general egg quality.
Also I forgot to mention in the first post after my husband had been taking the supps and continued diet change it completely reversed his dna fragmentation numbers. He went from 71% fragmented dna to 31% fragmented dna, it was a huge difference, even Dr Ramsay said it was ‘remarkable’.