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What is a Sperm DNA Fragmentation (SDF) test? 

A sperm contributes one-half of the genetic material to the child. Genetic material is the DNA, which is carried within the sperm. An intact DNA is essential for the health of the developing baby. If the DNA inside a sperm is broken into pieces, it is said to be fragmented. Fragmentation of sperm DNA could be one of the reasons for male infertility. It is known that SDF can be correlated with miscarriage, poor development of the baby in the womb and difficulty in carrying the pregnancy.

Regular semen analysis test for male fertility does not provide information about sperm DNA. An SDF test is now becoming a better predictor of fertility in men. In fact, it is increasingly becoming popular as the primary method for identifying male infertility.

The test could be used as an indicator of success before undergoing expensive processes, such as in-vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). It could also be used to track the success of such treatments.

  1. Why is an SDF test performed?
  2. How do you prepare for an SDF test?
  3. How is an SDF test performed?
  4. What do SDF test results indicate?

Sperm DNA analysis is recommended in the following cases:

  • Varicocele: Marked by enlargement of the veins in the scrotum, which could decrease fertility by increasing SDF
  • Unexplained infertility: A person may have a normal semen analysis test but may still not be able to father children. High SDF is usually the case of infertility in such cases
  • Frequent pregnancy loss: Fragmented sperm DNA leads to missing genes in the fertilised embryo and hence termination of pregnancies
  • Failure of intrauterine insemination (IUI) procedures: IUI is a methodology used to help couples with problems associated with infertility. Here, semen is artificially added in the uterus of a woman. A failure of this procedure could be due to fragmented sperm DNA
  • Failure of ICSI or IVF procedures: Higher values of SDF have been shown to be associated with abortions after the ICSI and IVF procedures. Doctors usually recommend an SDF test to check the reason for abortions after ICSI and IVF procedures

Men who are facing problems with fertility and are smokers or have been exposed to occupational hazards, such as polychlorinated biphenyls, are also recommended to get tested for SDF.

You must abstain from sexual intercourse 2-5 days before the test day. Since there are a few supplements that can interfere with the test, it is best to inform the doctor about any vitamins or herbal supplements you might be taking. Also, let your doctor know if you were recommended any medicines in the past or present.

For this test, a sperm sample is usually taken in a clinic in a private area through self-stimulation. The sample is collected in a wide-mouthed bottle. Some people may not prefer the self-stimulation method for religious reasons. Please let the doctor in such cases. They may provide the person with specialised condoms (which do not interfere with test results) for the collection of semen sample during intercourse. This sample is collected at home and needs to reach the laboratory within an hour. During the transport, it is necessary that the sample is maintained at body temperature.

Normal results: SDF test results are measured in different units, and the values may vary according to laboratory-specific standards. Normal results in an SDF test indicate that the DNA is nonfragmented, ie intact, and may not be the cause of any fertility problems. 

Abnormal results: Usually, higher than normal values are considered abnormal. Abnormal results mean that the DNA in the sperm is fragmented to the extent that could affect the development of the baby in the womb or the continuation of pregnancy. Fragmentation of DNA in the sperm could also be associated with genetic defects in the child.

In case of abnormal results, your doctor may recommend medication or lifestyle changes, which might help restore problems with sperm DNA quality. He/she may even recommend the couple to undergo treatments such as ICSI, wherein the sperm is taken directly from the testes.

The use of an SDF test in clinical diagnosis is still being researched. Most researchers show it to be beneficial for helping couples with infertility problems. However, it is not a routine test for accessing infertility in men.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

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References

  1. Pfeifer S et. al.The clinical utility of sperm DNA integrity testing: a guideline. Fertil Steril. 2013 Mar 1;99(3):673-7. PMID: 23391408
  2. Borges E Jr et.al .Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertil Steril. 2019 Jun 11. pii: S0015-0282(19)30408-X. PMID: 31200969
  3. Gemma López. Diagnostic value of sperm DNA fragmentation and sperm high-magnification for predicting outcome of assisted reproduction treatment. Asian J Androl. 2013 Nov; 15(6): 790–794. PMID: 23912311
  4. Kim GY. What should be done for men with sperm DNA fragmentation?. Clin Exp Reprod Med. 2018 Sep;45(3):101-109. PMID: 30202739
  5. Ashok Agarwal. Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios. Transl Androl Urol. 2016 Dec; 5(6): 935–950. PMID: 28078226
  6. University of Rochester Medical Center. Semen Analysis. Rochester, New York. [internet].