High DNA fragmentation advice

[Dbop100]

Hello

We've been ttc for almost 2 years. We thought for the last year the problem was my low AMH of 2.1. We just had a failed round of IVF after which we did some more tests.

The most surprising result is that my husbands DNA Fragmentation has come back high at 37% - all his other standard sperm tests have come back normal / good. But we've never tested for DNA frag before. Our consultant advised he take Impryl and improve his lifestyle, she couldn't advise how much of a problem it is for trying naturally but advised ICSI if we ever do IVF again. We had decided not to as I never seem to get more than 1 egg so seems fairly pointless. I still feel it's worth more investigation so we're still going to see a Urologist incase it's caused by something else. If we can ever get an appointment...

I'm just wondering if anyone else has had normal sperm apart from DNA frag? Or knows how much of a problem this actually is and if they know any other ways to improve? Any advice in this area is very much appreciated xx

Hi @Dbop100 sorry about your unsuccessful rounds and now stressful results.

We had a disastrous sperm frag result initially (far worse that yours) and saw a urologist (Mr Ramsay in London). He re-tested and it turned out all was fine. The tests have to be processed in a specific way and it seems as tho ours was done wrong. It was a stressful few months in which we thought we were totally infertile. The other possibility which was a theory put forward by Mr Ramsay was that my DP could have had Covid (maybe without knowing). He has been seeing lots of bad results that then improve and thinks that this could be a temporary after affect of Covid.

I think there are potentially other treatments that he can do depending on the cause. Some men have variocele which can be easily operated on. Others can have an infection. So it is worth exploring further.

Btw regular sperm tests don't test the same things as a DNA fragmentation test so it is absolutely common to have a normal sperm analysis alongside a problematic DNA sperm frag result.

Also I'm afraid ICSI or even PICSI (a more detailed procedure) can't help with DNA frag because the only way to see if a speed has DNA damage is to do the test you have just done which involves killing the sperm. So embryologists can't help with this one.

A bit also depends on your age. A bit depends on the proportion of moderately damaged sperm as well as the highly damaged. Even though you have low AMH if you are younger then there is a chance your eggs could correct for the moderate damage in his sperm. In my case because I am significantly older (44) my eggs couldn't compensate for this. So for us all damaged sperm was problematic but for someone younger you would only be considering the proportion of highly damaged. If that makes sense?

Best of luck with it. I know how devastating these diagnoses can be so sending you lots of good wishes xxx

Hi @Janefx40 thank you so much for your reply, it was so very helpful I really do appreciate it. We've got an appt now booked to see Mr Ramsay in a month.

I'm 34 and my husband is 37, we both had Covid quite badly (although we weren't hospitalised thankfully) last October so perhaps this has affected things? I would have thought it would have gone back to normal by now, but he's still getting headaches. Maybe after we've had both vaccines it'll start to improve?

Yes I was wondering how ICSI could possibly help but what you say makes more sense. I don't feel like my consultant really understands what DNA frag is, I had to ask 3 times for her to test him. Really hoping it's something we can improve as it looks like trying naturally is our only option now!

Thank you again xx

@Dbop100 great that you have an appointment. Mr Ramsay is amazing. In fact there is another thread on here about him. I will find you the link.

Just looked it up and our original comet results were:

ACS 47%
LCS 6%
HCS 36%

After re-testing a few months later our results were

ACS 25%
LCS 73%
HCS 0%

Johnathan Ramsay - experiences please www.mumsnet.com/Talk/infertility/4244992-Johnathan-Ramsay-experiences-please

@Janefx40 thanks for the thread!

Wow those results have improved amazingly, you must be so relieved! did he do anything else other than wait for the suspected Covid to pass?

Ours were:

ACS 37%
LCS 35%
HCS 12%

So you've given me some hope things can get better! X

@Dbop100 Well as I said Mr Ramsay concluded in our case it was likely to do with a testing error but he was also doing the normal things such as no alcohol, healthy diet, moderate exercise etc. He also takes Symprove on Mr Ramsay's recommendation but he'd only just started that when the tests were done.

It sounds like Covid could be a factor for you which hopefully means it will pass.

Your score isn't that bad either and bearing in mind your youngish age, it could be that your eggs can correct any damage anyway.

Rod Gilbert did a documentary about sperm that was really good. He's had years of IVF before anyone tested his sperm and then they found a problem that was treated with a simple antibiotic. It could be good to watch if your DH is struggling with the results.

I really hope things work out for you. Our second round of ICSI worked for us back in 2018 and we have a DD born when I was nearly 42 so miracles are possible. We're now back trying for a sibling which is a bit of a fools errand but we're giving it a go anyway

Best of luck xxx

Oh also we did the basic lifestyle changes and supplements from It Starts with an Egg (the IVF diet/supplement bible). We've not worn proper anti-perspirant for months!!...thank heaven for lockdown and home working...

Let me know how you get on x

Thank you! Really do appreciate your help. Wishing you all the very best with everything for you too XX

Hi all, I hope you don't mind me resurrecting this post, but I am literally in the same situation as you @Dbop100 and wondered whether you had an update on your situation?

We've just received my partners comet score:

ACS 37%
LCS 31%
HCS 10%

I also have low AMH of 3.3pmol.

Does anyone know what the low comet and high comet score means?

Also we have been on impryl for around 3 months now and it seems that this hasn't really made a difference, are there any other supplements that could work instead?

Hi @ohsheglows I'm afraid we're not much further on from where we were in June. We saw a Urologist Mr Minhas who did some more tests and determined that he couldn't find anything obviously causing the DNA frag. We've been improving diet (cut out caffeine, cut way back on alcohol) and lifestyle and taking Impryl and both doing acupuncture since then. It's been 3 months so we've got another consultation this time with Mr Ramsay in about 2 weeks. We'll see if he thinks we should retest or if there is anything else we can be doing. It feels very much like everything is on hold, we didn't see much point in doing any more treatment until we knew if we could lower the DNA frag.
My husbands results were very similar to yours. Not entirely sure what the high and low ones mean I just go by the average. As far as supplements go he's not on too much else but is about to start Chinese herbs via our acupuncturist. He feels it could be connected to his long Covid... which the acupuncture is helping with. Have you had any tests to check what might be causing it?

Hi @ohsheglows I recently read this study on the effect of antioxidants on dna fragmentation onlinelibrary.wiley.com/doi/full/10.2164/jandrol.04146 Taking 1g Vit C and 1g Vit E daily for 2 months really improved DNA fragmentation in the participants. My DP is giving it a go to see if it improves his results.

Ask about/look into into frequent ejaculation. Mr Minhas saw my husband & put him on Impryl & Proxeed. My IVF consultant then asked him to release every second day in the lead up, then daily during IVF right up until the night before egg collection. We were lucky to then have 100% fertilisation with ICSI.

Apparently very fresh sperm have lower DNA fragmentation.

@Dbop100 oh good luck with the appointment with Dr Ramsay, we've been seeing him and he's fab.

Well DH has been checked for a varicocele which was fine, and the ROS came back normal, and no infections. So I guess nothing that seems obvious. It was just a bit of a shock because I always thought my low fert rates were due to my poor quality eggs due my low AMH but it seems there could be another factor at play now!

@EmsTTC thank you! I might see if we can take this in addition with Impryl!

@Porridgeislife oh wow really? That's amazing. I've always had very low fert rates. Dr Ramsay said at my DH's last appointment said exactly the same thing - apparently frequent ejaculation lowers the DNA frag. When do you have your transfer?

@trying2022 not for another month or so. I don’t make many good eggs so they wanted to test the blastocysts and also run a few more tests on me before we did any transfers.

The other thing my husband did was lose nearly 2 stone - we followed the 5:2 diet - but I think the frequent releasing helped the most. He hated the supplements and really only took them every two days or so.

@ohsheglows a little update from me. We saw Mr Ramsay today, he was lovely. He suggested that we re-do the comet test, plus do an oxidative stress test, hormones etc. This time though he's been told to abstain for only 24hours before the test, he did the original test with 4 days abstinence as suggested by the IVF clinic. As it's been 3 months of lifestyle changes and almost a year since we had Covid he's hoping for better results 🤞

Thanks for the update @Dbop100 we actually went to see Dr Ramsey a week ago too! He is lovely isn't he. He made us feel really reassured, I only wish all doctors were like him. We found out hubby had a hidden infection which is why the dna frag was so high. Got given some antibiotics and because of my AMH, he said to continue with IVF next month 🤷🏻‍♀️ so we'll see.

How are you feeling about things? Do you have another round of IVF in the pipeline? I'll keep my fingers crossed that in 3 months things will improve for you!

@ohsheglows oh that's so great to have found the cause of the DNA frag. I kind of wished we had something obvious that could be fixed. But fingers crossed things are at least heading in the right direction with these next test results. If not he said even as they are now at 37% dna frag then the donor eggs are likely to work at the very least as they'll be stronger than mine.

Personally I don't think I'll go for more IVF, I only got 2 eggs, one of which didn't even make it to day 3, although we got a good day 5 embryo, just sadly didn't implant. I think we'll try and improve the sperm and try naturally for a while. If that doesn't work then we'll move on to Donor eggs. We don't really have enough money for both and I'd rather save it for DE. I don't see what IVF gives me if I'm only getting 1 good egg anyway. That's just my feeling on it, it's obviously wonderful for other people.

Good luck with your IVF next month! Really hope you have a successful round x

Hi everyone

We had a failed ivf in may and tested for dna frag and results were -

ACS 33%

LCM 49%

HCS 4%

Still don't really know if our diet and supplements have helped but we were told to diet and take Marion glenville vits for 90 days

We are retesting 6th Oct so time will tell

Xx

Hi everyone,

Just wanted to update in case this is helpful to anyone but after reading the paper I linked above re the 1g Vit C and E my DP had a repeat DNA fragmentation test and his results had improved from fair to poor to good to fair after only about 5 weeks. It may not be the vitamins but it might be worth a try as they are fairly cheap to buy.

I have just got a positive pregnancy test so hoping this is third time lucky for us after two MCs but still a long way to go.

Sending lots of luck to you all 🍀

@EmsTTC that's great news thank you for sharing. Is this from a natural cycle or Ivf ?

We've just had 2nd comet down and get the results in a couple of weeks so hoping diet and supplements have helped. Xx

Hi @strawberrysummer19 it's from a natural cycle.

I hope you get the results you want and the two weeks don't go too slowly (I've never known time go so slow as when TTC lol).

Lots of luck 🍀🍀🍀

@EmsTTC thats or my to hear such lovely news

Thank you I hope so xx

@EmsTTC hi not sure you've seen from other threads but we got the results early and we've just started our next cycle! The results were low enough for us to be able to do ivf xx