sperm DNA frag - Q&A from local message board

sperm DNA frag - Q&A from local message board

Mrs. A
Mrs. A

May 9th, 2011, 4:29 pm #1

This is probably of more interest to Katie but posting as follow up to thread we were having recently.

I posted on the message board of a local clinic:

QUESTION:
Under what circumstances do you order a sperm DNA frag test?

If the DNA frag comes back higher than acceptable range, what is the prescribed course of treatment/solution?

ANSWER:
we don't -----there is no normative data so we don't know how to interpret results. For example, what percentage of abnormal sperm suggests poor fertilization or embryo development or implantation or health risks...or need for donor sperm for that matter?? we don't know. So, the results generally do not change management.

________________________

Separately I do have a callback scheduled with Dr. Check tomorrow on a personal matter, but as I mentioned on the original thread I'll ask him re: this test too (assuming time allows )
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BabyDance
BabyDance

May 9th, 2011, 4:37 pm #2

As I understand it, the only treatment is supplements?
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Mrs. A
Mrs. A

May 9th, 2011, 5:14 pm #3

to know that if there is an issue you can go on supplements to improve the DNA frag.

But I was trying to see if the response I got came back with ICSI because that's what 4 different REs had told me.

I don't think it's something to dismiss, most especially if you are going to do donor egg. That was when I was planning on getting the test done for my DH. I must admit though that if it had come back high I don't know if I'd been able to convince DH to ingest all sorts of supps without the backing of some doctor.

More that I think about this though. Is donor sperm routinely checked for sperm DNA frag? Do you know, Babydance, since you have used?
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Anonymous
Anonymous

May 9th, 2011, 5:23 pm #4

This is probably of more interest to Katie but posting as follow up to thread we were having recently.

I posted on the message board of a local clinic:

QUESTION:
Under what circumstances do you order a sperm DNA frag test?

If the DNA frag comes back higher than acceptable range, what is the prescribed course of treatment/solution?

ANSWER:
we don't -----there is no normative data so we don't know how to interpret results. For example, what percentage of abnormal sperm suggests poor fertilization or embryo development or implantation or health risks...or need for donor sperm for that matter?? we don't know. So, the results generally do not change management.

________________________

Separately I do have a callback scheduled with Dr. Check tomorrow on a personal matter, but as I mentioned on the original thread I'll ask him re: this test too (assuming time allows )
But basically the test will show what % of DNA frag is in the one sample, and from there they can give you an idea of chance for a live birth. Anything over 30% is very bad with a live birth rate near zero frankly. You really want to try to get it below 15%. Lots of tips to get improvement besides supplements seem to really help. It isn't always a matter of black-and-white "you failed you need donor sperm" that makes so many people scared to test at all.

There is a lot of misinformation out there about the value of the test, and some REs are getting better educated on it. CCRM and SIRM are among the clinics who want the test done, and it's an easy test compared to what us females go through.
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Mrs. A
Mrs. A

May 9th, 2011, 5:35 pm #5

and that if moving on to DE it's a good idea to get the test done,
I didn't really research this a whole lot. Probably because of the mixed reaction I got from the REs.

It seems like you are more aware of the test and course of action. Based on the response I got back from the message board RE, do you know if there is "normative data" available?

Is donor sperm routinely checked for sperm DNA frag? If you use donor sperm how do you ever get to know if the sperm you're using has low or high sperm DNA frag?
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Joined: January 13th, 2011, 3:54 pm

May 9th, 2011, 5:37 pm #6

This is probably of more interest to Katie but posting as follow up to thread we were having recently.

I posted on the message board of a local clinic:

QUESTION:
Under what circumstances do you order a sperm DNA frag test?

If the DNA frag comes back higher than acceptable range, what is the prescribed course of treatment/solution?

ANSWER:
we don't -----there is no normative data so we don't know how to interpret results. For example, what percentage of abnormal sperm suggests poor fertilization or embryo development or implantation or health risks...or need for donor sperm for that matter?? we don't know. So, the results generally do not change management.

________________________

Separately I do have a callback scheduled with Dr. Check tomorrow on a personal matter, but as I mentioned on the original thread I'll ask him re: this test too (assuming time allows )
There IS something to do. ICSI does not sort out sperm with DNA frag. But there are several other procedures that do separate out the DNA frag sperm. These techniques are standard IVF practices in a number of other countries. And although the U.S. leads in research, clinical practice lags WAY behind. One technique is called PICSI. There are very few clinics in the US that offer it.

Obviously supplements help with motility and sperm count, but Im not sure it helps with DNA problems.
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Mrs. A
Mrs. A

May 9th, 2011, 6:36 pm #7

http://art.biocoat.com/products.htm

I just found this blog post - it's very informative!!

http://murgdan.blogspot.com/2009/06/spe ... -scsa.html

http://murgdan.blogspot.com/2009/06/spe ... picsi.html

Here's ASRM's position on this:

"...current methods for evaluating sperm DNA integrity do no reliably predict outcomes, and no treatment for abnormal DNA integrity has proven clinical value."

http://www.asrm.org/uploadedFiles/ASRM_ ... tility.pdf

Now I see why the RE posted the message that she did on the message board.

Also, from reading the blog post I see that the blogger was also given similar info I was.
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BabyDance
BabyDance

May 9th, 2011, 7:26 pm #8

to know that if there is an issue you can go on supplements to improve the DNA frag.

But I was trying to see if the response I got came back with ICSI because that's what 4 different REs had told me.

I don't think it's something to dismiss, most especially if you are going to do donor egg. That was when I was planning on getting the test done for my DH. I must admit though that if it had come back high I don't know if I'd been able to convince DH to ingest all sorts of supps without the backing of some doctor.

More that I think about this though. Is donor sperm routinely checked for sperm DNA frag? Do you know, Babydance, since you have used?
I don't know if DS is checked. I doubt it since they are usually young and have such high counts and other parameters. Did you get so far as to find our what supplements? I know high doses of carnitine and pycnogenol are recommended.
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Joined: January 13th, 2011, 3:54 pm

May 9th, 2011, 8:13 pm #9

http://art.biocoat.com/products.htm

I just found this blog post - it's very informative!!

http://murgdan.blogspot.com/2009/06/spe ... -scsa.html

http://murgdan.blogspot.com/2009/06/spe ... picsi.html

Here's ASRM's position on this:

"...current methods for evaluating sperm DNA integrity do no reliably predict outcomes, and no treatment for abnormal DNA integrity has proven clinical value."

http://www.asrm.org/uploadedFiles/ASRM_ ... tility.pdf

Now I see why the RE posted the message that she did on the message board.

Also, from reading the blog post I see that the blogger was also given similar info I was.
First, the PICSI link? yup that is it. Notice the comments made by the ASRM are from 2008. That's a long time ago in terms of the IF field! Great article links...I think those really do a good job of explaining this issue.

I actually have quite a good working knowledge of statistics and medical research in general, so these are meaningful to me (and hopefully to others!).

The first link shows us how DNA fragmentation was the single best predictor of pregnancy success with donor sperm. And this is a large sample, really well designed study (which means it has lots of reliability and validity):

http://www.ncbi.nlm.nih.gov/pubmed/21486427
Summary of findings- "Conclusion: Both the integrity of plasma membrane and DNA in spermatozoa are crucial factors affecting the fecundity of sperm donors. Therefore, the addition of some of these new tests to routine semen analysis could significantly improve the recruitment of sperm donors and the clinical pregnancy rate of anonymous donors."

This second link focuses just on IVF couples. It shows the same thing...DNA frag is a major predictor of success/failure:

http://www.ncbi.nlm.nih.gov/pubmed/21462126
Summary of findings- "Abnormality of sperm chromatin structure is one of the reasons for IVF-ET failure. Examination of sperm chromatin structure is helpful in predicting the risk of IVF-ET failure and optimizing treatment of infertility."

And yet another link, with similar results:

http://www.ncbi.nlm.nih.gov/pubmed/21299480
Summary of findings- "This study shows that fertilization rates are directly dependent upon both sperm progressive motility and DNA fragmentation, but sperm DNA fragmentation is a much stronger test."

These are about the relationship between DNA frag and miscarriage:
http://www.ncbi.nlm.nih.gov/pubmed/21269883
http://www.ncbi.nlm.nih.gov/pubmed/18757447

For me, these are a big deal...we had an early m/c. And I am not just going to keep letting these docs tell me that it is because of my egg quality when it might actually be something else...and something we could fix!!! We can't fix my eggs...bet there are techniques to fix this issue!

I must say, the more I look into this, the more I am convinced that this should be a standard part of our screening. As I have mentioned, we are waiting for the approval to get DH tested. Insurance might actually pay for it. But even if they don't, we will go out of pocket.

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SMRC
SMRC

May 9th, 2011, 8:14 pm #10

http://art.biocoat.com/products.htm

I just found this blog post - it's very informative!!

http://murgdan.blogspot.com/2009/06/spe ... -scsa.html

http://murgdan.blogspot.com/2009/06/spe ... picsi.html

Here's ASRM's position on this:

"...current methods for evaluating sperm DNA integrity do no reliably predict outcomes, and no treatment for abnormal DNA integrity has proven clinical value."

http://www.asrm.org/uploadedFiles/ASRM_ ... tility.pdf

Now I see why the RE posted the message that she did on the message board.

Also, from reading the blog post I see that the blogger was also given similar info I was.
As someone who had the tank for this test delivered to her office (!!) and getting her DH to do this test tonight, I'm very appreciative of this string. I'll contribute as I can with any further info I garner - I planned to consult with Dr. Spandorfer at CRMI on any results and will post then. Dr Goldstein at CRMI who focuses on male factors issues (and who works closely with Dr. Sammi David) pushed hard for us to get this test done and we'll probably also consult with him too.
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