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Should You Consider Sperm DNA Integrity Testing? Maybe, Maybe Not Yet

Whether this particular test might be right for you depends on your individual situation. As always, talking with your infertility specialist can help in making the right decisions for you when it comes to evaluation, diagnosis and treatment.
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Today, any couple facing problems in getting and staying pregnant benefits from ongoing medical advances that result in new techniques to diagnose and treat infertility. Among those are tests of sperm and embryos that may better predict and therefore improve outcomes such as sperm DNA integrity testing.

Many don't realize that male infertility can affect all aspects of having a baby including getting pregnant, normal embryo development and having a healthy child. Therefore, testing to determine male fertility and the likely success of different treatment approaches is an important clinical goal. And, of course it's important to couples trying to have a baby! Conventional semen analysis has not proven to be a reliable predictor but sperm DNA integrity testing might be - at least in the near future.

We all carry genetic material in our DNA and the DNA in sperm can be analyzed for damage. Generally, men who are infertile tend to have higher levels of sperm DNA damage. Currently, several different types of tests are used to analyze the general health of sperm DNA using a sample, including:
  • Sperm chromatin structure assay (SCSA) testing
  • Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay
  • Single-cell gel electrophoresis (COMET) assay

To date, a number of studies link such damage to problems with sperm function affecting poor embryo development, decreased implantation rates, and miscarriage. Other studies show no association.

For now, existing data doesn't show a consistent relationship with abnormal sperm DNA and pregnancy outcomes. Test results combined with different infertility treatments demonstrate there is not yet enough evidence to show that any specific sperm DNA integrity test technique can accurately predict fertility or miscarriage when combined with any treatment. So, the test can't yet reliably be used to predict if a couple can get pregnant using intrauterine-insemination (IUI), in-vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI) or if they are likely to miscarry.

Still, infertility specialists are hopeful that improvement in techniques and further research may lead to clinical validation for using the tests. This is important as assisted reproductive techniques - especially ICSI - can help men create pregnancies who otherwise couldn't, making it critical to learn about the underlying causes of their infertility. That makes it important to evaluate the quality of sperm genome.

More - and better - published research is needed on the value of sperm integrity testing since previous research has used small populations, different testing methods, and not controlled for other factors that might affect the outcome. Test predictability may improve with additional research, as new techniques are developed, and current techniques are better understood.
For now, sperm DNA integrity testing is still considered "experimental" and not recommended for those undergoing routine fertility evaluation. The hope is that in the not too distant future the tests can be used to distinguish between fertile and infertile men and help determine which infertility treatments might be most effective.

Whether this particular test might be right for you depends on your individual situation. As always, talking with your infertility specialist can help in making the right decisions for you when it comes to evaluation, diagnosis and treatment. While nobody really likes tests, this might be one worth taking - if not today, maybe sometime soon...

For more information on fertility visit us at ARCFertility.com.