This might be the missing piece of your fertility picture

Sperm DNA fragmentation is damage to the genetic material carried inside the sperm cell. The sperm can be the perfect shape, moving at the perfect speed, and in the perfect numbers, but still have broken DNA. Unfortunately a standard semen analysis cannot see this.

Sperm DNA fragmentation is associated with:

- Failed fertilisation despite good embryo quality

- Poor embryo development and early arrest

- Recurrent implantation failure after IVF

- Recurrent miscarriage (particularly early losses)

- Unexplained infertility

DNA fragmentation is caused by:

- Oxidative stress. This is free radical damage to the sperm cell membrane and nuclear DNA that accumulates when the body's antioxidant defences are overwhelmed. Poor diet, smoking, alcohol, heat exposure, environmental toxins, chronic stress, varicocele, infection and age all elevate oxidative stress.

- The seminal microbiome matters. An imbalanced bacterial environment surrounding the sperm directly increases oxidative stress and DNA damage.

You will be told there is not anything that can be done about sperm DNA fragmentation but it’s not true. The powerful and amazing thing is that men make a completely new batch of sperm every 74 days, every single one is replaced! This means that sperm DNA fragmentation, however high it is today, is not fixed or permanent. It is a reflection of the last 74 days of diet, lifestyle, oxidative stress and environmental exposure. Change those things and you change the fragmentation index at the next test. Targeted antioxidant therapy has published evidence for reducing sperm DNA fragmentation meaningfully within 1-2 74-day cycles. Alongside dietary and lifestyle changes and addressing the seminal microbiome.

If you or your partner has had unexplained infertility, failed IVF cycles, recurrent miscarriage or poor embryo quality, and a sperm DNA fragmentation test has never been done, ask for one. This is not a niche concern, it is a central piece of the fertility picture that is being systematically missed.

I work with both partners, because 40-50% of fertility challenges involve male factor and the full picture needs to be investigated fully.