Improve Sperm DNA Integrity?

mtlaurel

Just got the results for DH's DNA frag. test - DFI: 36.6%

I know that our current RE will likely be dismissive of these results, but they concern me. My DH is very upset, and I don't think able to wrap his mind around tx other than DE at this point... So, I'm wondering whether anyone's DH tried the antioxidant therapy S.her writes about and saw an improvement. If so, how long did it take to see improvement? Thanks.

reb259

mtlaurel:

Just got the results for DH's DNA frag. test - DFI: 36.6%

I know that our current RE will likely be dismissive of these results, but they concern me. My DH is very upset, and I don't think able to wrap his mind around tx other than DE at this point... So, I'm wondering whether anyone's DH tried the antioxidant therapy S.her writes about and saw an improvement. If so, how long did it take to see improvement? Thanks.

H is going for this test 8-24. What does that % mean? What is normal range? What did they say in terms of being able to get pregnant. Sorry for all the ?'s

Mrs.McIrish

I am very sorry. I don't understand how your current RE can be dismissive of these results.  Shouldn't it be under 15%?      If new sperm is generated very 90 days, I would think you'd need to try the therapy for at least 3 months (not what you want to hear I know).    Hopefully some of the MFI ladies will chime in.

SweetDahlia

I'm sorry I don't know. DH will also be doing this test when we get back to going to the RE. I keep moving my new RE appt.

I hope you get some answers.

Edwina.McDunnough

FOR IUI AND TI:

=15% = excellent to good

>15 to <25% good to fair 

= 25% fair to poor (and IVF with ICSI is recommended)

+++

Please please please remember theses assessments are for TI/IUI and that being in the "must use ICSI" category is not the kiss of death. It just means that ICSI would he indicated and that you may have a few less competent embryos than otherwise, but that doesn't mean you have none. And you just need one. If you look at the numbers, the majority of his sperm are still very very good and it really looks to me ICSI has been tipping the balance accordingly for your DE cycle if not for all of them. HUGS !!!! I know any bad news is harder than hard and it feels like the hits keep coming. I wish good things for you both and that you're able to discuss this your RE soon.

 

 

vanessagorc

Edwina is right about the percentages.  Be aware some drs will rec donor sperm at that level of frag....bc they are often going to rec icsi above 14 percent. Dh's uro is adamat that u do not let this test decide if u move to ds.  He said u need to see the embroyo quality first...an then consider the test results w that.  

 

Really, nothing can be done to improve the frag...it pretty much is what it is.  U any change ur DNA. Good luck! 

vanessagorc

Also, I'm not sure where u live... But pet.er sch.legel is considered to be te best mfi uro in the country (out of Cor.nell). I'm confident we owe this baby to him.  

mtlaurel

I also just got partial results for my RPL tests - no clotting disorders, only one level was elevated that would potentially indicate the use of Folgard (won't know more details until I talk to dr.).

I should have explained the DNA frag results - yes, he falls into the "recommend ICSI" category, which we've used with every cycle. I asked about the DE embryos we did not transfer this cycle, and a couple made it to blast, but were severely degenerated and fragmented at that point.

So, with our severely limited funds, our history of not having embryos make it to blast (OE) or being very poor quality when they do (DE), and these results on DH, I am not sure how comfortable I am trying DE again.

I have read abstracts of studies showing oxidative stress can damage sperm DNA and that antioxidant therapy can result in less fragmentation. The trouble is that there are not enough well-controlled studies that link such tx to positive pregnancy results... Just curious if anyone's else's DH tried it and saw improvements in the DFI.

vanessagorc

My honest opinion is that if sch.legel doesnt reccomended it ( and he does not) than its not worth it. 

mtlaurel

vanessagorc:

My honest opinion is that if sch.legel doesnt reccomended it ( and he does not) than its not worth it. 

Thank you

Mrs.McIrish

V-  sorry if this is a dumb question but if she already used ICSI and her embies didn't get to day 5 using DE (taking out the eqq quality issue), what is her option? Just keep trying until the embryologist can pick a "good sperm" that doesn't have the frag?

reb259

Mrs.McIrish:

V-  sorry if this is a dumb question but if she already used ICSI and her embies didn't get to day 5 using DE (taking out the eqq quality issue), what is her option? Just keep trying until the embryologist can pick a "good sperm" that doesn't have the frag?

i think i read something somewhere that if they take directly from the testes the sperm is in better condition and less frag. Otherwise maybe ds? For some reason this is very confusing to me and i know i will be in the same situation soon. :-( Glad we are discussing this...

reb259

mtlaurel:

I also just got partial results for my RPL tests - no clotting disorders, only one level was elevated that would potentially indicate the use of Folgard.

i also have this mutation...i was told it affects like 30% of women.

mtlaurel

reb259:

Mrs.McIrish:

V-  sorry if this is a dumb question but if she already used ICSI and her embies didn't get to day 5 using DE (taking out the eqq quality issue), what is her option? Just keep trying until the embryologist can pick a "good sperm" that doesn't have the frag?

i think i read something somewhere that if they take directly from the testes the sperm is in better condition and less frag. Otherwise maybe ds? For some reason this is very confusing to me and i know i will be in the same situation soon. :-( Glad we are discussing this...

I've read this, too. Not sure we'd find an RE willing to do that with his moderate results, though. I appreciate V weighing in with S.chelgel's opinion, but I am willing to give antioxidant therapy a try if that's what DH wants to do. If he re-tests closer to a DFI of 15% in a couple months, I'd entertain the idea of doing DE again. S.cher recommends 6-8 weeks of antioxidants (because oxidative stress occurs after sperm is generated) so it's not that long to wait.

vanessagorc

mtlaurel:

reb259:

Mrs.McIrish:

V-  sorry if this is a dumb question but if she already used ICSI and her embies didn't get to day 5 using DE (taking out the eqq quality issue), what is her option? Just keep trying until the embryologist can pick a "good sperm" that doesn't have the frag?

i think i read something somewhere that if they take directly from the testes the sperm is in better condition and less frag. Otherwise maybe ds? For some reason this is very confusing to me and i know i will be in the same situation soon. :-( Glad we are discussing this...

I've read this, too. Not sure we'd find an RE willing to do that with his moderate results, though. I appreciate V weighing in with S.chelgel's opinion, but I am willing to give antioxidant therapy a try if that's what DH wants to do. If he re-tests closer to a DFI of 15% in a couple months, I'd entertain the idea of doing DE again. S.cher recommends 6-8 weeks of antioxidants (because oxidative stress occurs after sperm is generated) so it's not that long to wait.

UGH, i just typed a long response and the bump ate it!!!!!!!!!

 Basically this is the position we were in...36 good eggs retrieved and only 1 good blast (this is a horrible ratio for mfi only).  Its like looking for a needle in haystack.  We were given the option of continuing w IVF (looking for a decent sperm) vs DS.

DS would have likely been faster and cheaper, but dh wanted to keep trying w his swimmers (we were lucky that we did not have to make the decsion based on finances).

Our next step was to do a fresh and fert 2-3 eggs w ds and the rest w dh's swimmers.  Then we would compare to see just how much of a diff there was.  We would have frozen them and thought about our next steps, if they were good.  We opted to try our 1 frostie before this.

 reb-when the sperm is that highly fragmented, there is some thought that u can get better from the source...thru tese.  Sch.legel only does mTESE bc he believes that gives u access to the best pockets of sperm.  He invented the mtese, so everyone else learned it from him.   The drawback is tese sperm is always immature.  So u have to weigh the level of frag vs knowing the sperm is immature.  Bc immature poor quality sperm, can't even fert.  Dh was on his mtese schedule 2x, it's packed w people from all over the world.  The waiting room is like the united nations.

 It was a long and costly process for us, and i'm happy to share what i learned.

Mtlaurel-of course, try whatever u want...I can only share what i learned.  If u are close enough to him, id def consult with him.  He is truly a genius in this field and is the leading researcher.  We were lucky we were able to use him.

Edwina.McDunnough

mtlaurel:

I also just got partial results for my RPL tests - no clotting disorders, only one level was elevated that would potentially indicate the use of Folgard (won't know more details until I talk to dr.).

I should have explained the DNA frag results - yes, he falls into the "recommend ICSI" category, which we've used with every cycle. I asked about the DE embryos we did not transfer this cycle, and a couple made it to blast, but were severely degenerated and fragmented at that point.

So, with our severely limited funds, our history of not having embryos make it to blast (OE) or being very poor quality when they do (DE), and these results on DH, I am not sure how comfortable I am trying DE again.

I have read abstracts of studies showing oxidative stress can damage sperm DNA and that antioxidant therapy can result in less fragmentation. The trouble is that there are not enough well-controlled studies that link such tx to positive pregnancy results... Just curious if anyone's else's DH tried it and saw improvements in the DFI.

Gotcha, I am remiss by not knowing your whole story. V is a wealth of information on the subject and I defer to her experiences with Dr S.  HUGS, I just wish it weren't this difficult. Hoping your complete RPL panel comes in soon.

mtlaurel

car seat:

My H had 37% frag when we first had this test run, and it was a big blow.  Our RE put him on a supplement to try to improve the numbers.  He took Coast Reproductive Male Fertility (labelled as a male prenatal) for three months and they re-ran the test.  I can't remember the new number, but I think it was somewhere around 20-25%.

We've still done ICSI for every IVF cycle, but the supplement did appear to give us some quality improvement.  We've also had multiple losses and there's some link between sperm fragmentation and early miscarriage, so he is pretty dedicated about taking these things for several months leading up to retrieval.

I don't know if this was helpful at all, but I'm sorry that you're dealing with this.  It's hard to have that extra stress, especially with how much you've already been through.  Good luck!

This is helpful - thank you.

LaLe09

My DH hasn't been able to do the DNA test due to his severely low count. We are trying with another lab now with a new Uro to see if they will be able to run it. As far as the supplements go, as you stated, there is some research saying that there is some improvement with sperm. However, no results on improving pregnancy rates.

I wanted to try everything, even if there wasn't going to be a much of a change. So DH is on clomid, arimidex, conception xr, acetyl l carnitine, co q10, fish oil... and I think that's it. He also changed his lifestyle habits this year and now exercises regularly, eats healthy, doesn't drink as much, etc.  So far, we've seen 0 improvement. (But that's just based on count, not DNA frag). It's very disheartening. i know i've read of some ladies on here whose husbands have seen an improvement. Not sure if that's just coincidence or if it was a result of lifestyle change/supplements.

Wishing you luck on whatever your next steps will be!

reb259

What's confusing to me is my H has always had good SA and we get a good fert rate...embies arrest by day 5. 

I know V you have said the sperm really does what it needs to day 4 and 5 so I guess that is where are issue is.  If H's sperm can fert and can't continue development, would that still be a frag issue?

As I mentioned above H has an appot with a RE Uro on 8/24, I guess we will hopefully get some answers by then.

mtlaurel

reb259:

What's confusing to me is my H has always had good SA and we get a good fert rate...embies arrest by day 5. 

I know V you have said the sperm really does what it needs to day 4 and 5 so I guess that is where are issue is.  If H's sperm can fert and can't continue development, would that still be a frag issue?

As I mentioned above H has an appot with a RE Uro on 8/24, I guess we will hopefully get some answers by then.

Exactly my concerns. We had an average fert rate with OE, and a 100% fert rate with DE. However, our embies turn to crap after d3 in all cases. In my mind, this indicates problems with sperm DNA. I'll be asking my RE about this next week, though she doesn't even know we had the frag. test done.

I have read that DNA fragmentation can be high, even with otherwise normal SA parameters. I hope you can get some better answers from the uro. you're going to see, and that you'll keep us updated.

reb259

mtlaurel:

reb259:

What's confusing to me is my H has always had good SA and we get a good fert rate...embies arrest by day 5. 

I know V you have said the sperm really does what it needs to day 4 and 5 so I guess that is where are issue is.  If H's sperm can fert and can't continue development, would that still be a frag issue?

As I mentioned above H has an appot with a RE Uro on 8/24, I guess we will hopefully get some answers by then.

Exactly my concerns. We had an average fert rate with OE, and a 100% fert rate with DE. However, our embies turn to crap after d3 in all cases. In my mind, this indicates problems with sperm DNA. I'll be asking my RE about this next week, though she doesn't even know we had the frag. test done.

I have read that DNA fragmentation can be high, even with otherwise normal SA parameters. I hope you can get some better answers from the uro. you're going to see, and that you'll keep us updated.

Sadly we seem to have very similar situations.  Is your H seeing someone local, a reproductive uro?  Now that you have your results maybe it will help to seek someone out for a path forward.  I will keep you posted on our next steps...hope you keep me updated too!

mtlaurel

reb259:

mtlaurel:

reb259:

What's confusing to me is my H has always had good SA and we get a good fert rate...embies arrest by day 5. 

I know V you have said the sperm really does what it needs to day 4 and 5 so I guess that is where are issue is.  If H's sperm can fert and can't continue development, would that still be a frag issue?

As I mentioned above H has an appot with a RE Uro on 8/24, I guess we will hopefully get some answers by then.

Exactly my concerns. We had an average fert rate with OE, and a 100% fert rate with DE. However, our embies turn to crap after d3 in all cases. In my mind, this indicates problems with sperm DNA. I'll be asking my RE about this next week, though she doesn't even know we had the frag. test done.

I have read that DNA fragmentation can be high, even with otherwise normal SA parameters. I hope you can get some better answers from the uro. you're going to see, and that you'll keep us updated.

Sadly we seem to have very similar situations.  Is your H seeing someone local, a reproductive uro?  Now that you have your results maybe it will help to seek someone out for a path forward.  I will keep you posted on our next steps...hope you keep me updated too!

Our situations do sound similar. We saw a uro. over a year ago. He was very difficult to get into see and wasn't particularly helpful, other than recommending ICSI. I mentioned going back to him again before we got these results, and DH didn't seem too interested. I'll also mention V's recommendation since we're in the region. DH has a lot to think about right now, and wasn't willing to talk too much last night. I will keep you posted on where we go from here.

vanessagorc

reb259:

What's confusing to me is my H has always had good SA and we get a good fert rate...embies arrest by day 5. 

I know V you have said the sperm really does what it needs to day 4 and 5 so I guess that is where are issue is.  If H's sperm can fert and can't continue development, would that still be a frag issue?

As I mentioned above H has an appot with a RE Uro on 8/24, I guess we will hopefully get some answers by then.

this is our issue too. That's what a 3dt is useless for me. We will only ever do 5dts now, even if it results in nothing. We have awesome fert rates...but most arrest on day 4. Given I have no issues, uro and re believe it's the poor quality sperm.  Could be fragmented or poor in a diff way. They have no way of telling, they just watch the development (or lack of).  Thats also why they wanted to see how a couple donor sperm did.  To see if the diff was drastic and clearly rule that it wan not the egg.

vanessagorc

mtlaurel:

reb259:

mtlaurel:

reb259:

What's confusing to me is my H has always had good SA and we get a good fert rate...embies arrest by day 5. 

I know V you have said the sperm really does what it needs to day 4 and 5 so I guess that is where are issue is.  If H's sperm can fert and can't continue development, would that still be a frag issue?

As I mentioned above H has an appot with a RE Uro on 8/24, I guess we will hopefully get some answers by then.

Exactly my concerns. We had an average fert rate with OE, and a 100% fert rate with DE. However, our embies turn to crap after d3 in all cases. In my mind, this indicates problems with sperm DNA. I'll be asking my RE about this next week, though she doesn't even know we had the frag. test done.

I have read that DNA fragmentation can be high, even with otherwise normal SA parameters. I hope you can get some better answers from the uro. you're going to see, and that you'll keep us updated.

Sadly we seem to have very similar situations.  Is your H seeing someone local, a reproductive uro?  Now that you have your results maybe it will help to seek someone out for a path forward.  I will keep you posted on our next steps...hope you keep me updated too!

Our situations do sound similar. We saw a uro. over a year ago. He was very difficult to get into see and wasn't particularly helpful, other than recommending ICSI. I mentioned going back to him again before we got these results, and DH didn't seem too interested. I'll also mention V's recommendation since we're in the region. DH has a lot to think about right now, and wasn't willing to talk too much last night. I will keep you posted on where we go from here.

I can't rec the uro enough. He's hands down the best IMO. Even if ur thinking about it, I'd make an appt.  the wait can be long and u can always cancel