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

Morning @strawberrysummer19,

Thanks amazing news! 🥳🥳🥳🥳 Please keep me updated on how your IVF cycle goes. I will keep everything crossed for you 🤞🏻🤞🏻🤞🏻🤞🏻🍀🍀🍀 x

Hi all

Just a little update from us. My husband re-tested recently and we just had the results back today. His DNA frag has gone from 37% up to 50% and his count went from 36mil to 4 mil. So overall pretty bad 😩

We're not sure what happened, he's been improving his lifestyle diet etc, we did start Chinese herbs which Mr Ramsay said to stop. But overall he thinks it's linked to my husbands long covid.

Next step it to do another test with ZYMOT to see if they can find some good sperm. If that doesn't go well then we might need to think about donor sperm. With my low AMH I was already thinking about donor eggs which I had got my head around my this is really upsetting to think we could potentially both need donors.

Anyway just thought I'd share our update as I like to see what happens when I read these threads.

Oh no! I'm so sorry @Dbop100, that's so bizarre that the count went down and the dna frag increased.

Sounds silly but does your OH work out with training leggings? We eventually realised that my partners dna frag was caused by these super tight leggings he used to wear when going outside. He's only allowed to wear shorts now.🙄

I'm so sorry to hear about this @Dbop100, could you consider going another round of IVF with the sperm from the zymot? I know it's extra time and money too 😞

Thanks @ohsheglows I'm afraid no such leggings can be blamed in our case, I'm really hoping there is something we can find that can be easily fixed, this sudden reduction in sperm count is very strange he's never had this problem before.

If the ZYMOT helps we'd definitely think about more IVF, but as my AMH is so low I think we'd only get maybe 2 eggs I wonder if it's worth it and we should just go straight to Donor eggs...

It's all so much money and feels like such a gamble it's hard to know what the right thing to do is.

Wondering if there is a good clinic for both low AMH and sperm in London or if best to go abroad now too...

How did your IVF go I re-read that you said you were going for another round?

Hi @Dbop100 it's so hard isn't it. I thought about donor eggs too but there aren't any guarantees for that too so I'm a bit conflicted about what to do if our frosties don't work.

I am currently in my 2WW but I stupidly tested today at 6dp5dt and no line so I think I'm out this month.

Then 2 of my friends announce their pregnancies, and I'm just sitting here thinking when is it my turn 🤷🏻‍♀️

You must tell me how your ZYMOT goes!

@Dbop100 I'm sorry to hear that. You must be so puzzled as to how the results have changed so much. I guess in this case it is a process of elimination.
@ohsheglows that's still quite early so you're not quite out just yet.
I'm 4dp5dt just behind you x

@Dbop100 mine is also low, what is yours if you don't mind me asking? X

@ohsheglows yes I'll definitely update after the ZYMOT test is done. I'm quite curious about it.

@strawberrysummer19 my AMH was 2.1 a year ago, not tested again since. I've just turned 35 and I got 2 eggs and from that 1 day 5 blast in April but sadly it didn't take, that was before we knew about my husbands high DNA frag though.

Best of luck to you both with your 2ww, it's the hardest time 💕

If either of you rates your clinics I'd love a recommend I think we're looking for a new on but will keep working with Mr Ramsay as well.

@Dbop100 so my AMH was 5.6 but I got 9 eggs on first cycle and 7 eggs on second cycle so more than my AMH indicated so was happy with that.

I only got poor grade early blast from cycle 1 but after cycle 2 we got 2 excellent ones from 4 fertilised so I was very happy

Our first cycle we didn't test for dna frag however my DR didn't want us to cycle again until we dieted and took supplements - it worked for us and I think our clinic took the dna frag quite seriously - so I would recommend ours. I'm not sure if another clinic would be better for low AMH but I only picked mine on location.

@strawberrysummer19 great that you got 2 blasts, which protocol were you on? Was it the same for both rounds? I did natural modified.

Do you mind my asking how low you got your DNA frag down to to be good to go ahead with another round? Did you end up doing ICSI or normal IVF? X

@Dbop100 I know I www so shocked
Very high dose of menopur- believe it was the top dose 450
Short protocol - both same each times
Dr didn't want to change it as it worked well producing a good number of eggs Considering low AMH

I was prescribed DHEA and took 3 a day so I think that contributed

Regarding lowering it we were recommended Marion glenville supplements
I upped his vitamins and got excellent quality ones from Holland and barrett
omega 3 - 1000mg
Vit e - High dose
Co10 we took high strength 600grams

We changed to no or low sugar where we could
We more really strict for 2 months then fell off the wagon the last month !
The diet was for 90 days then we tested again and got good results
They said we were in the perimeters of IVF and didn't end up needing icsi

Please ask if you have any questions x

Hi Everyone,

I hope you don’t mind me joining in…

Just to give you a bit of background:

My DS- conceived naturally - he is 4…

Struggled to conceive after this- secondary infertility…

1. ivf- chemical
2. ivf- got pregnant and sadly lost my pregnancy at 22 weeks due to cervix related issues (now have stitch in place)
3. ivf bfn
4. ivf chemical (Pgs tested embryo)
5. ivf chemical

So- we have now moved to argc… I am about to start my period in the next day or two… had all the tests with argc- my immunes are fine (one came back slightly out of range which they said they may treat alongside my stims)

Most surprising out of everything is that my husnands DNA frag came back at 36%.

I am really surprised that they are suggesting that I still start on this cycle… they have suggested PICSI…

Since reading these forms I have booked In to see a urologist, Prof Minhas ( I wanted to see Mr Ramsay but can’t get an appt until Dec)

My questions:

What do I do? Do I proceed with this cycle with PICSI? Any success stories with this?
I have heard that ICSI/ PICSI doesn’t work with DNA frag as you still can’t tell if the sperm is fragmented? Is this true?

What about surgical sperm retrieval?

Do I delay my cycle? I have low Amh (3.1) and am about to turn 38 so dont really want to do this… do I just do this cycle with PICSI abd see what happens?

Sorry for the long post…

X

Hi @Mummmmyyyy gosh it sounds like you've been through a lot. All I can say is what I would personally do which is to delay the cycle until your partner has met with a urologist. The ideal way to deal with DNA frag is to bring it down before you do IVF because ICSI/PICSI etc doesn't really fix it. You never know the Urologist may find something wrong that can easily be fixed and it can be lowered and you can go into your next round feeling more confident about the sperm.

Also we did a similar thing and met with Mr Minhas because Mr Ramsay had a longer waiting list and then regretted it and ended up seeing Mr Ramsay 3 months later (not because it was a 3 month waiting list but because it took that long to test, get results, etc) Mr Minhas was fine but my husband wasn't that happy with his advice and much prefers Mr Ramsay who I feel is much more thorough.

Again just my personal take, you've got to do what's right for you, I totally get how hard it is to wait especially when you have low AMH. I personally don't feel most IVF clinics take sperm DNA frag seriously enough so I would defo get the opinion of a sperm specialist before proceeding.x

Hi ladies

I’m 37 and have been TTC my first for 2.5 years. I had my amh tested a year ago and it was very low (2.3pmol). So no NHS funding.

In Aug we had an IVF cycle at the Lister where 4 eggs were retrieved. We had to convert to ICSI because they discovered my partner has anti-sperm antibodies (the sperm was all clumped together). Even with ICSI we had no successful fertilisation.

We were advised to do DNA fragmentation and the results weren’t good. Along with that and the antibodies (AND my low amh) the whole thing felt devastatingly pointless and I’d started to research donor embryos with a heavy heart.

My partner was sent to have more tests to look for hidden infection etc. We are waiting on the results. It was suggested that next round we do IMSI which is higher magnification of the sperm than ICSI.

By some miracle I’ve just discovered I’m pregnant naturally. This has obviously been an ENORMOUS shock to us as we assumed that was virtually impossible. Delighted of course but also so terrified that this will end in miscarriage. We’ve tried for so long to get this far and I can’t bear to go back to the start!

I’m not sure if this is the right question for this group as maybe no one has been in the same situation, but has anyone had a successful birth despite the bad sperm issue? Or any other words of reassurance to not feel completely panicked the whole time? Just feeling like this is doomed. Thanks in advance 😔

Hi @Misty84 congratulations! I'm sorry I don't personally have anything I can share with you that will make you feel better about this but I am keeping everything crossed for you. I guess all you can do is take things one day at a time. Please keep us updated. Do you mind me asking how high your partners DNA frag was?x

@Misty84 congratulations! Whilst I don't know the answer to your question - I'm also recently pregnant (partner had bad dna fragmentation ) found out after a failed ivf round - We were advised to diet and take supplements for 3 months - see my posts in this thread) and I wonder the same - even though his dna fragmentation came down but we ended up with two good blasts and I'm now 5wks with one
I'm trying to be positive and think what will be will be - if it was good enough to go back, implant we just have to believe we have every chance ! Easier said than done though x

Hi @Dbop100 thanks so much for replying. Yeah trying to stay calm and take things one day at a time.
My partners results in September were:
ACS: 43%
LCS: 14%
HCS: 32%
I’ve read through everyone’s posts and his results are easily the worst!! (apart from when you mentioned the increase to 50%). What’s the current/next step for you?

@strawberrysummer19 Oh congratulations that’s wonderful, I’m not far behind you, I’m 4w+4. I still don’t feel like I’m talking about myself when I talk about pregnancy! It didn’t/doesn’t seem possible.

Just adding this photo for some extra clarification. It was truly the most awful results to read (along with when I received my AMH!)
You would not think someone could successfully fertilise an egg with these results hey?!

@Misty84 oh wow we are close !
I know I feel exactly the same. I don't really have lots of symptoms- only little ones
I've had strong tests, strong beta but still ordered a digital for tomorrow !! Then I'll stop and await my early scan! X

@Misty84 that's really incredible isn't it
But my DR did say to me there was every chance we could fall naturally
Your body is very clever at selecting the best quality!! It's so hard to accept isn't it but it sounds like it's very common and lots of women worry when we are so early
That's what I keep telling myself anyway!! X

@Misty84 I mean it's pretty amazing but also pretty brilliant and gives the rest of us some hope!

Mr Ramsay said 37% would probably have worked fine with Donor eggs as 'stronger' eggs can correct the DNA frag so maybe you got really lucky and released a strong egg?

Yes his last result from a test in September was 50% but we remembered after our consultation he'd had an awful stomach bug the week before so really hoping that was a factor. He just retested along with the additional Zymot chamber yesterday and we'll get the results in 3 weeks so fingers crossed for an improvement - although I managed to get a stomach bug on Monday and really hoping I didn't pass it to him and mess up another set of results - it's so bloody expensive testing all the time!

Maybe an early scan will put your mind at ease? Let us know how you go.x

Massive congrats to you too @strawberrysummer19 please also keep us posted x

@Dbop100 yes will do, I'll be sure to check in as like you say it really does give hope. Xx

Hi there, just wanted to add my two cents to this discussion as have some experience in this area.

When you get the comet scores and the average score is say 40% that is saying across the board the average DNA frag in the sperm they looked at is 40%. You can still have lots of sperm in the sample that have in fact low/very low levels of DNA Frag that could quite easily fertilise an egg and you will have no problems. This is why ICSI for example in some cases can circumvent high DNA Frag because they never actually know the level of DNA Frag in the sperm they pick that may end up fertilising the egg. Currently they can't test DNA Frag and then still have the sperm viable to use. Therefore it is just a game of percentages really and yes quite obviously if you have a higher DNA ACS score on comet you are more likely to have poor quality sperm selected for IVF/ICSI or that fertilise an egg in natural conception. However it certainly doesn't mean you are doomed! In fact younger eggs (under 35 years of age) can generally correct up to 40% frag. Hope that helps.

Hi @Sperminator500 (love the name btw) yes I think the thinking at the moment is to use the Zymot Chamber to naturally select the good low dna frag sperm from the bad high dna frag before ICSI. The test we just did puts the sperm through the zymot chamber than does a DNA frag test on those that made it through. If it proves to produce better results we might try zymot and ICSI next x

@Dbop100 good luck with the zymot device and dna frag. Would be interested to know if it significantly drops the DNA Frag (I suspect/hope it will do, as they will all be hardcore progressively motile to get through the maze in the device). I don't see any detriment in using zymot if you can for ICSI. It can't make things worse right?

The interesting thing for me is if zymot turns out to be a bit of a miracle for DNA Frag, then potentially all the DNA Frag Testing companies will lose a substantial portion of their income and possibly become obsolete. Have you taken a look on the reddit dna fragmentation thread? There is lots of good info on that website and some good examples or people having used it.