General Question
A couple between 29 and 33 years of age, with no fertility problems, has a 20 to 25% chance of conceiving on any given month. After 6 months of trying, 60% of couples will conceive without any medical assistance. If after one year of sexual intercourse without contraception, pregnancy is not achieved, the couple is considered infertile. The male factor is responsible for 34% of cases of infertility, while 30% of cases have an unfavourable diagnosis for both the woman and the man. It is for this reason that early, comprehensive semen analysis can identify potential problems to avoid embarking upon costly and repeated Assisted Reproductive Technology (ART).
Conventional semen analysis only studies spermatozoa concentration, motility and morphology. It is an incomplete study, as it omits analysis of one of the most important parameters, the integrity of the DNA molecule. In addition, knowing the levels of oxidative stress and the quality of the spermatozoon’s membrane guarantees a better diagnosis for subsequent fertility treatment. 15% of men who are considered infertile present normal semen analysis results
DNA fragmentation, excessive oxidative stress, and the lack of vitality in the spermatozoon correlate directly with a low fertility rate and with failures in embryonic development. This translates into an increase in the number of cycles needed to achieve pregnancy through IUI (Intrauterine Insemination), IVF (In Vitro Fertilization) or ICSI (Intracytoplasmic Sperm Injection), deterioration of embryo quality and repeated miscarriages.
Based on the percentage of fragmentation, level of oxidation and vitality of sperm cells, your medical professional will validate the semen sample and, together with the semen analysis, will decide on the reproductive technique and treatment that is most appropriate to increase the likelihood of success.
Treatment with antioxidants may significantly reduce levels of DNA fragmentation. The response to treatment varies as a function of the causes that can cause said damage: if this results from toxic factors or high temperatures that activate sperm caspases and endonucleases, it is difficult to modify levels of DNA fragmentation in sperm.
Spermatozoa that come from the first portion of the ejaculate have lower levels of DNA fragmentation. On the other hand, repeated ejaculation or the use of spermatozoa originating in the testicle can achieve similar results depending on the type of patient. The effectiveness of these strategies must be evaluated by your medical professional in each case, which varies among patients.
DNA fragmentation is important when it comes to selecting a couple’s assisted reproductive technology. It has been demonstrated that it is related to the probability of full-term pregnancy during IUI cycles. Levels above 30% reduce the likelihood of success from 19% to 1.5%. Knowing this data, we can select alternative techniques to IUI. In IVF treatments, fragmentation levels below 25% lead to a live birth rate of 33%. With fragmentation levels greater than 50%, this rate falls to 13%.
He patient just has to follow the instructions of his medical professional. They will need a semen sample, which will be processed by the laboratory personnel, following a rapid and easy-to-follow established laboratory protocol.
A DNA fragmentation level greater than 30% is considered risky, and it is therefore considered that there is a male factor associated with the reproductive failure.
Sperm DNA damage is a multifactorial process. Tobacco use, obesity, tight clothing, ingestion of certain drugs, fever, advanced age, chemotherapy or radiotherapy, are environmental factors that can produce an increase in sperm DNA fragmentation levels. Some natural factors like improper maturation or oxidative stress translate into failures during the production of spermatozoa in the testicle, which result in the same response.
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