DNA fragmentation refers to the presence of fragmented DNA within sperm cells where high levels of fragmented DNA can hinder the ability of sperm to fertilise eggs effectively, leading to infertility, the creation of poor-quality embryos and an increased risk of miscarriage. The DNA Fragmentation Index (DFI) is a specialised test that measures the extent of DNA fragmentation in sperm.

In an interview with HT Lifestyle, Dr Sneha Sathe, Fertility Consultant at Nova IVF Fertility in Chembur, shared, “Although not routinely recommended for all couples experiencing fertility issues, the DFI test is advised in certain situations. These include long-standing infertility, multiple failed intrauterine insemination (IUI) cycles, previous IVF cycles with poor embryo quality, or low blastulation rates (The percentage of embryos that reach the blastocyst stage and are ready to go for transfer or freezing).”

Causes of High DFI

According to Dr Sneha Sathe, several factors can contribute to high DFI, including:

• Infections

• Environmental pollution

• Lifestyle choices such as smoking, alcohol, and drug use

• Medical conditions like diabetes, obesity

Impact of High DFI on IVF/ICSI Cycles

Dr Sneha Sathe revealed, “High DFI can negatively affect the outcomes of in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) cycles. It increases the risk of producing poor-quality embryos or embryos that do not reach the blastocyst stage, a critical step toward achieving pregnancy. A blastocyst forms about five to six days after a sperm fertilises an egg. Furthermore, high DFI raises the risk of miscarriage.”

Management of High DFI

Dr Sneha Sathe suggested, “If a sperm DFI test reveals high levels, the male partner will be advised to take antioxidant supplements and make lifestyle changes, including diet modification, regular exercise, and stress management through activities like yoga and meditation. For couples where the male partner has high sperm DFI, IUI cycles are generally not recommended. Instead, IVF with ICSI is suggested.”

She added, “During an ICSI cycle, on the day of egg retrieval, the male partner provides a sperm sample. Techniques such as the Zymot Slide (Sperm Separation Device), PICSI (a tailored form of ICSI for selecting healthier sperm), or MACS (Magnetic-Activated Cell Sorting) may be used to obtain sperm with lower DNA fragmentation. Additionally, when DFI is high, men are advised to have shorter periods of abstinence before providing their semen sample, as this can reduce the DFI on the day of the sample collection.”

Asserting that high DFI can significantly impact fertility outcomes but with proper management and advanced techniques, couples can improve their chances of successful conception, Dr Sneha Sathe concluded, “It is crucial to consult a fertility specialist to address any concerns and receive tailored guidance for overcoming infertility challenges. For more personalised advice and to clear any doubts regarding high DFI and fertility treatments, visiting a fertility consultant is essential. Timely intervention and expert care can make a significant difference in achieving successful pregnancy outcomes.”

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