DNA fragmentation test before IVF/ICSI?

[estebancolberto]

We are planning to start with ICSI soon as we have male factor infertility issue. However, before starting I'm wondering whether it makes sense to do a DNA fragmentation test? Based on that test result, we could decide which IVF clinic would better suited to address the DNA fragmentation issue? I read that clinics that use Zymot or TESE can handle DNA fragmentation? We don't want to spend thousands on ICSI only to find out negative results/miscarriages later. Instead, would make sense to do DNA fragmentation test first?

Hiya firstly sorry that you’re here. We have severe MFI so also going through ICSI. Unfortunately we can’t do a DNA frag test as we don’t have enough numbers. I’m not sure of details of your MFI but I would seek a urologist to see if you can get any help to improve the numbers before IVF as this can save you doing multiple rounds going in with the best chance. Also in certain cases things like zymot can damage sperm further and increase DNA frag so a urologist can help advise the best course of action. I’m not sure where you are based but Jonathan Ramsey in London is amazing

good luck !

@estebancolberto i have low amh which we thought was the sole issue. My husband then had dna frag test which revealed higher than average sperm dna damage. We were referred to either Mr Ramsey or Mr Tet Yap - they are urologists who specialise in male fertility. We saw Mr Yap because wait list for Mr Ramsey meant we’d have to wait for months to see him. Mr Yap was amazing and very knowledgeable. Husband had significant varicoceles which Mr Yap thought was causing the dna damage. He referred my husband for embolisation at the NHS which was done within six weeks. After three months we had our second ICSI cycle this time with Zymot as recommended by my ivf doctor and Mr Yap. They didn’t mention anything about zymot damaging the sperm and I don’t think I read about that either. Do ask them about this though as it is an important consideration. It does however filter out sperm that are not strong enough so maybe not advisable for men with very low count? So far we are successful after the second cycle, I’ll be 12 weeks next week. Good luck OP.

Hi OP. I think it would be a really smart idea to test before IVF. Our test led us to the decision to cycle in Spain instead of Ireland as they have the right technology (zymot, Mac) and better labs more experienced with high frag. In Ireland we were told "this test doesn't matter because the treatment is the same: ICSI" which is absolutely inaccurate. I dread to think how poorly our cycles would've gone with my low AMH and DH's MFI, especially considering I'm 40 now. We're banking so no transfers yet but have 5 blasts in the freezer using ICSI and zymot.

Also recommend a Urologist or at the very least a clinic with an andrology or male factor department that is willing to investigate your partner. Mitigation is important but so is an attempt to reduce the frag as that's going to improve your outcome in IVF.

100% yes to do it. However go for the extend (sometimes known as comet) We were unexplained for years. Had three rounds on the NHS- over 48 eggs collected between those three rounds. Amazing fertilisation, however day 3 they always started to struggle and we only ever made 2 blasts (one chemical, one missed miscarriage) My husband sperm tests and standard dna test came back with great results but no one could tell us if it was egg or sperm that was causing our embyros to fail on day 3. I got told by many consultants day1/2: it’s the egg day 3: hard to know day 4/5: it’s the sperm quality. However after my final failed ivf round (11 eggs collected, 11 fertilised, all made it to day 3 but were behind and I was advised a day 3 transfer which ultimately failed!) we went to see Lynne Chapman- she really listened; looked at my history , my rounds and advised this test. I fully believed it was my egg quality that was the problem. We had the test through fertility solutions (wasn’t cheap £900 but worth every penny!) and it turns out 86% of my husbands sperm is fragmented. We have decided to stop our journey with fertility but it’s nice to know we have the reason. If I could go back and have had this test done I quite possibly wouldn’t have wasted all those rounds. So yes, absolutely do it but go for the extend as it is a lot more in depth and will uncover issues if there are any. I wish you the best of luck …xxx