Can embryos still be made with high DNA frag

[TSHconfusion]

My husband and I have had one cycle of ICSI for MFI which resulted in 6 embryos. We have so far transferred 4 of these embryos (1 fresh single transfer, 1 single FET, 1 double FET) and had negative tests each time.

I am wondering if we were to do another cycle would it be worth him having a DNA frag test before it? We had thought that because we made embryos ok that DNA frag wasn’t an issue but I’m wondering is it possible to make these apparently high quality embryos but could it be high DNA frag causing them to not implant? Any advice welcome please!

You should take a look at Drtimchild on instagram as he does a lot of instagram lives and this comes up regularly. Did you have PGT testing done? My understanding is that it can have an impact and also can be a cause for miscarriage as well. It may be worth doing the test and if needed visiting a urologist like Dr Ramsey.

@confused2025 thanks for the recommendation will definitely look him up. Our embryos are untested but think if we do another round we will go with the testing. I think we will do the dna test and then possibly go for something like zymot next time. Just so frustrating feeling like we’ve wasted our NHS round now because they refuse to acknowledge DNA fagmentation

Is there definitely confirmed dna frag? Failed implantation can happen for loads of reasons and from what I see from my research that it can be inflammation that can cause it mostly. It’s so tough but hopefully you will find root cause x

@confused2025 no we haven’t did the test I’m just trying to see if it’s worth us doing it before doing another round but I think it would be as something else to rule out. I’ve had a hysterscopy and there were no findings so my consultant thinks that we’ve just been really lucky so far especially as we are transferring untested embryos which I really hope is the case but definitely want to do more testing to try and find a cause.

by inflammation do you mean inflammation that would be picked up on a hysterscopy or more microbiome testing?

More microbiome and if you’re feeling stressed, It might be good if you haven't already, to try acupuncture or reflexology ahead of your next transfer and do the dna frag test. I think it really helps to know what’s happening rather than just being told ‘unexplained’. I really hope everything works out for you x

@confused2025 I did have acupuncture in the lead up to our last FET and I really enjoyed it but I don’t think it really did too much tbh. I usually am quite relaxed when we’re actually going through treatment and then get more stressed in between because I just hate the waiting around feeling like things aren’t progressing. Thanks so much and thanks for taking the time to respond. Are you going through treatment also?

I understand. The waiting is horrible. I just finished my second cycle x

It is worth doing DNA frag before starting another round with those results and existing MFI. High DNA frag and damage from having a varicocele can reduce the chances of making it to live birth. Fixing a varicocele you need to wait 3 months after it to start another round. If it's something else, your partner may need antibiotics, hormones or supplements which they also need to take for 3 mos. Most IVF clinics are not experts in MFI and give conflicting/out of date info. In London either Tet Yap or Jonathan Ramsay whose name you will see a lot here. They will be able to look at the whole picture on the male fertility side and give you proper advice. On your side, you can do the EMMA/ALICE tests for uterine inflammation and microbiome. There is also the fertilysis test which is similar. You may have been unlucky with untested embryos, like others have said, so it's about how much you want to test everything and remove those factors.

Hey. See my latest reply on the Unexplained Infertility thread for our experience. Get the DNA frag test. I am now of the opinion that it is a full-blown medical scandal that it is not taken seriously and tested at the beginning - especially in cases like ours where there is a known varicocele. Our experience is similar to yours so far. 4 blasts. 1 failed fresh. Doing first FET next week but could not be less hopeful about it given what we now know about DNA frag. Trying to get my husband in for an embolisation asap given the need to wait at least 3 months afterwards to see improvements. So sorry you are experiencing this too!

Also want to add, I asked Jonathan Ramsay this exact question on Friday. He said that looking at our first ivf results so far - 100% fertilisation rate, 4 blasts of good enough quality to freeze, he thinks it unlikely that high dna frag would render them all useless. And that if the semen used had been poorer quality, we would have been unlikely to get those results. Apparently the eggs can ‘fix’ the sperm dna damage, to a point. Women saving men’s asses, just another case of!

I said, ‘So to sum up you’re saying if the dna quality of his sperm sample had been that bad, we wouldn’t have made 4 blasts?’
He said: ‘Correct.’

I’ve heard him, but am finding it hard to let myself believe it after so much disappointment (never seen a bfp) and have hope that our remaining 3 embryos could work. That said, he was hopeful one would. So fingers crossed I guess.

What was interesting about our case is that my husband’s first sample on egg collection day was deemed unsuitable for ivf due to too high a level of ‘debris’ (possibly caused by an infection, results tbc). So he ended up having to do another only 3hrs later. Apparently short abstinence periods can help with dna frag, so we (inc Ramsay) wonder if this is why we got a good result. Maybe with a longer abstinence period the fertilisation rate would have been worse. So anyone worried about dna frag, that could be a (free!) thing to try.

Thanks so much for all your advice!! Can I ask how yous have got the diagnosis for a varicocele please? It is not something that has ever been mentioned to us that could be a possibility.

we are going to transfer our last 2 embryos and if they don’t take will definitely do the fragmentation testing before going any further. But that does make me feel better that dr Ramsey did agree it would unlikely to get so many good looking embryos, we were told on the day the semen sample looked great but sounds like they can’t actually see that much just with ICSI perhaps.

@TSHconfusion My husband has had his since he was 13. He got an infection that caused swelling and that damaged his veins and left him with a varicocele. He knew it could impact fertility (but not always - some 15% of the male population have one) so after 6 months of trying to conceive he went to the GP. The GP dismissed it as a problem that could be causing infertility seeing as his basic semen analysis came back normal (albeit mostly low normal). Cue lots more investigations on me that all came back clear and so next step ivf. Our fertility clinic don’t even offer the dna frag test. The varicocele was mentioned and again dismissed.

Given we still had no answers for our infertility and are yet to have success with ivf (admittedly only done 1 fresh transfer so far but it was a high quality embryo from looks, albeit untested), we booked to see Jonathan Ramsay. He examined my husband and said his varicocele was large and will “80% certainly” be causing high dna frag.

If you go to the GP they will do an examination and possibly an ultrasound to diagnose it. If it is big it can feel like a ‘bag of worms’, usually in the left testicle, sometimes with a dull ache especially when standing up or exercising. If you can I would definitely recommend Mr Ramsay for male fertility. Or Mr Yap or Mr Minhas who also have great reputations.

Your plan sounds good given there’s no indication of varicocele that you know of. In my case I wanted that checked while we still had embryos to try from this round, as now he can get it fixed and give his sperm time to improve before our next go, concurrently with our transfer attempts, without there being a long empty wait of doing nothing.

From what I gather ICSI can’t select the sperm with the least dna frag, you’d need the Zymot chip for that. ICSI I think just selects the best looking/moving sperm. Good luck!

Thanks for sharing all this - just waiting for our first transfer of 6 embyros from a retrieval cycle in July. My partner has a large externally palpable varicocele diagnosed when he was a teenager. His SAs show very high count but low/normal morphology. It's reassuring to see what Dr Ramsay said to you about the number of embyros being an encouraging sign.

I have a really complex gyne history so the focus has been on me, but I am worried about DNA frag. We're entitled to 3 retrievals and/or 6 transfers. As we made 6 embyros, our NHS funding will be used transferring them all, no more egg retrievals, so I'm afraid they're all duds!
With hindsight I wish we'd tested first, but too late now!

Good luck to you.

@Rankin11 Thanks! Best of luck for your first transfer. 6 embryos is great! If it helps I have just got my first ever positive test from one of our embryos from before my husband had his varicocele embolised (that is booked for next week and he is excited to get it done for comfort let alone fertility). Obviously super early (just 4 weeks… before most people find out!) but still a big milestone and fingers crossed all progresses well from here. I am perhaps more anxious knowing what we do about his varicocele (not got the dna frag results yet) but nothing I can do about that now. Trying to focus on the happiness of our first bfp even if I definitely do not assume after everything we have been through that bfp = baby.

Hi...sorry to comment on an old thread and I am really sorry if doing so triggers any upsetting feelings. But I was wondering how everyone got on/any updates you would be kind enough to share? My partner has known DNA fragmentation so we had zymot, but we have had two failed FETs so far. I can't really find any conclusions about whether the DNA fragmentation could still be causing implantation failure. We got 8 good quality embryos so I was hopeful the fragmentation was no longer an issue but now I'm not so sure! I'm just terrified of another failure really and trying to figure out how likely it is our third transfer will also fail.

@Klmno hi! So sorry to hear about your failures I truly know how hard it is. We never ended up doing the DNA frag test as our last transfer worked and I am currently 17 weeks pregnant! I hope this brings you some hope. We never really good any answers on why none of the others took but we transferred 6 embryos in total, 4 transfers (2 doubles) and the last one was successful. Everything should far is going smoothly with the pregnancy so hang in there I really hope you’re next one is the one for you

Thank you so much for taking the time to reply to me. Delighted to hear that after a tough journey you finally had some success! It also gives me some hope. I hope the rest of your pregnancy continues to go smoothly!