What is sperm DNA damage
Half of the genetic information to make us is delivered by the sperm to the egg. It takes around two months for a mature sperm to be made and during this time the DNA of the sperm may become damaged.
A number of different tests can be to assess the level of DNA damage in your sperm. There is some evidence for a relationship between sperm DNA damage and the outcome of fertility treatment. However, the evidence is conflicting and depends on the type of test used by the clinic.
Are there any risks?
Sperm DNA damage testing is a non-invasive procedure performed on a semen sample, usually before treatment as an additional diagnostic test. There are no significant additional risks to the patient.
There are a number of tests for sperm integrity that have been used to assess levels of DNA damage. The one most widely researched that we have chosen to use is the Sperm COMET test.
Studies have demonstrated a longer time to natural conception and lower IUI/IVF success rate in those with higher sperm DNA damage levels even with normal sperm numbers (Bungum et al, AJA 2013). We therefore consider sperm DNA testing in those with otherwise unexplained cause of subfertility as this may play a factor to help guide need for treatment and also treatment choice (i.e. recommend ICSI if damage levels high). Our data confirms an inferior IVF success rate in these couples which is corrected by ICSI unless the levels are particularly high at which point we recommend a urological opinion to assess for any underlying cause (Nicopoullos et al, BFS 2018).
Evidence of a link to recurrent miscarriage has also led to a recommendation to consider testing also in these scenarios (ESHRE guideline, Recurrent Miscarriage 2016).
There is currently no HFEA “traffic light rating” for treatments relating to sperm DNA damage. Read more about the HFEA traffic light system on fertility “add ons”.
A fertility “add-on” is an “optional extras that you may be offered on top of your normal fertility treatment, often at an additional cost. They’re typically emerging techniques that may have shown some promising results in initial studies but haven’t necessarily been proven to improve pregnancy or birth rates.”