Consider DNA Fragmentation Analysis:

When you have abnormal sperm (bad or borderline semen analysis results).

High levels of sperm DNA damage are linked to reduced chances of natural conception, with longer timeframes and lower success rates noted in couples with high DFI. Studies suggest that when DFI exceeds 20%-30%, the likelihood of natural pregnancy decreases. DFIs above 30% are associated with further decreased pregnancy rates. Recurrent miscarriages have also been correlated with high DFI, indicating lower sperm DNA integrity in couples who experience miscarriage. Couples experiencing unexplained infertility often exhibit significantly elevated DFI, particularly those above 30%, which significantly reduce the likelihood of natural conception. So strong is this correlation that some studies have shown that DFI could be used as a prognostic factor for natural pregnancy (and IUI) success rate.

When you can’t get pregnant and have a baby through IVF (when your assisted reproduction and your IUI/IVF/ICSI fails).

While studies examining the impact of Sperm DNA Fragmentation on IVF and ICSI outcomes yield variable results, a strong consensus exists regarding its association with increased pregnancy loss rates in these procedures. Despite the potential efficacy of ICSI for sperm with high DFI, paternal factors and elevated DFIs are linked to impaired embryo development and early pregnancy loss during ART. Abnormal DFI has also been significantly associated with reduced pregnancy rates, while clinical pregnancy rates are higher when the DFI is below 27%. Also, reports have revealed significantly higher DFIs in couples with RPL than in couples without RPL.

When you have detected Infections and/or Dysbiosis with your Male microbiome test.

Male reproductive tract infections and imbalances can lead to increased levels of sperm DNA fragmentation (DFI). They can cause inflammation and oxidative stress, which in turn can damage sperm DNA, resulting in higher DFI levels. Interestingly enough, bacteria which are considered beneficial for women such as Lactobacilli can be a significant source of oxidative stress and inflammation for men and vice-versa. High levels of ROS can be generated by seminal leukocytes act as a response to a wide range of infection-related and/or inflammation-related stimuli in the male genital tract, especially in the accessory sex glands, including the seminal vesicles and prostate. Infiltrating leukocytes in seminal plasma produce 1,000 times more ROS than the spermatozoa.

When you have a varicocele, when you are older or live in a high-risk lifestyle and environment.

Varicoceles, enlarged veins in the scrotum, can raise testicular temperature, harming sperm quality and DNA integrity. Oxidative stress, caused by environmental toxins, smoking, alcohol, and certain health conditions, can also damage sperm DNA. Advanced paternal age may contribute due to age-related cellular decline and decreased DNA repair capacity. Lifestyle choices like poor diet, obesity, sedentary habits, and stress are associated with increased DFI. Additionally, medical treatments such as chemotherapy, radiation therapy, and some medications can induce DNA damage in sperm.

Following a DFI test, your next steps depend on your results. DFI levels have been generally categorized in three main groups:

Normal or low DFI:

Typically, a DFI of less than 15% is considered normal or low. This indicates that a majority of the sperm cells have intact DNA and is associated with better fertility outcomes.

Borderline or intermediate DFI:

DFI percentages between 15% and 30% are often classified as borderline or intermediate. This suggests a moderate level of DNA fragmentation and may indicate a potential decrease in fertility. Additional testing and evaluation may be necessary to determine the underlying causes and appropriate interventions. This result suggests a potential reduction in fertilization capacity. Its clinical significance should be assessed by a fertility specialist considering the patient's medical history and other laboratory findings. Maintaining a healthy lifestyle and considering mild antioxidant supplements like Vitamins E and C, Carnitine, and coenzyme Q10 is advisable. Additionally, ruling out and treating male reproductive tract infections is essential before or alongside any interventions mentioned above.

High DFI:

DFI percentages above 30% are generally considered high. This indicates a significant level of DNA fragmentation, which can adversely affect fertility. High DFI levels have been associated with reduced pregnancy rates, increased risk of miscarriage, and lower success rates in assisted reproductive techniques. Antioxidant supplementation and addressing reproductive tract infections are also important steps in optimizing fertility. Further investigation by your doctor is advised to identify potential sources of oxidative stress and sperm DNA damage, such as inflammation or infection. While directly treating very high DFI can be challenging, testicular sperm extraction (TESE) offers a viable option for severe male factor infertility cases. TESE involves retrieving sperm directly from the testes, bypassing the reproductive tract where DNA fragmentation occurs. This approach can provide healthy sperm for use in assisted reproductive techniques like intracytoplasmic sperm injection (ICSI), potentially improving fertilization and pregnancy outcomes.

NOTE:

It's important to note that these classifications may vary among different laboratories or researchers. Additionally, the interpretation of DFI results should always be done in conjunction with other semen parameters and fertility evaluations to get a comprehensive understanding of male fertility potential.