r/dnafragmentation • u/kod2121 • Aug 19 '26
Suspicious of high dna fragmentation
My husband and I had 2 losses in 2023, then a healthy successful pregnancy in 2024, and now 2 losses as we try for #2. We’re going to get his sperm dna fragmentation test soon. We have had the whole RPL testing done, from karyotype, blood clotting disorders, hormones, SA, thyroid. Only things we haven’t tested yet are sperm dna frag and testing for endometriosis (and immunology potentially).
He also had a scrotum ultrasound in 2025 (he thought he had testicular cancer and his anxiety got the best of him). The ultrasound results came back all clear and indicate no varicocele. He doesn’t smoke, doesn’t do marijuana, eats relatively healthy, and drinks (not heavily).
Do you think he could have high dna fragmentation, and that’s could be why we’re experiencing so many losses?
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u/colonelfudge Aug 19 '26
My husband has a minor varicocele and had a 37% dna frag score with a four day abstinence period. When we dropped it to two he had in the low teens I believe. The test is relatively inexpensive compared to the years of treatment we did, so doesn’t hurt to try it.
Have you done a hysteroscopy? I had 4-5 SIS/HSG all come back completely clear across two different clinics, and then we did an exploratory hysteroscopy and found I had a uterine septum they had to remove.
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u/kod2121 Aug 19 '26
Yes I had a hysteroscopy done in June (after my 3rd loss). All was normal. One tiny tiny polyp in my cervix. Should I get another one?
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u/Upset_Membership82 Aug 22 '26
Definitely get it tested. It is typically a symptom of something else and in my case it was an infected prostate - prostatitis. My ultrasound was also clear!
The good news is I had a great doctor and got my issues resolved, and we had our little rainbow baby after 6 MCs
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u/kod2121 Aug 22 '26
Thanks for the response. This is interesting. What were your symptoms? 6 miscarriages - that’s terrible. How did you get your issue resolved? so happy you have a rainbow baby!
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u/Upset_Membership82 Aug 27 '26
Thank you!
So ultimately it came down to a £9 course of antibiotics. I’m sure there’s elements of luck, of all the lifestyle changes I had made to improve my SA etc but I’m pretty sure it was the antibiotics because it happened about 7 weeks after I started making serious lifestyle changes and I appreciate sperm takes 12 weeks to be made or so! The other change was the antibiotics so I’m going to say it was mostly that
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u/SnooPears226 Aug 19 '26
I say might as well test, but I had a similar story, healthy pregnancy then miscarriages and everything came back normal. Did Lovenox even though no blood clotting disorders and they said it helps with inflammation and any blood clotting disorder that might appear when pregnant. I hope you find answers soon, it’s so hard not knowing the reason!
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u/Chocholategirl Aug 20 '26
Can you share where you had your endometriosis and immunes testing ?
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u/kod2121 Aug 20 '26
I haven’t had the endo or immunology testing done yet. My RE suggested it as a next step. The endo test is through hernova and it’s a blood test ($700). The immunology test is a whole work up through Pregume ($1800).
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u/DrBrianSteixner Aug 25 '26
Yes, it is absolutely possible for your husband to have elevated sperm DNA fragmentation despite a normal semen analysis and no varicocele on ultrasound, because routine semen testing does not measure DNA integrity. Given your history of four pregnancy losses and one successful pregnancy, checking sperm DNA fragmentation is reasonable and is supported by male-infertility guidelines in the setting of recurrent pregnancy loss. Elevated DFI has been associated with increased miscarriage risk, although it is important not to assume it is the cause until you have the result; chromosomal abnormalities arising in the embryo and female factors can still contribute, and having a healthy child does not exclude elevated or fluctuating DFI. If his DFI is elevated, I would have him evaluated by a reproductive urologist. The specific DFI percentage and assay used (SCSA, TUNEL, Comet, etc.) matter, so once you have the result, that will tell us much more about whether it could realistically be contributing to the recurrent losses and what, if anything, should be done next. Hope this helps!!
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u/kod2121 Aug 25 '26
Thank you! This is very helpful. If he does have elevated dna fragmentation, what are the treatments?
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u/DrBrianSteixner Aug 25 '26
No problem. If his DNA fragmentation comes back elevated, treatment is usually aimed at finding and correcting whatever is causing sperm DNA damage, rather than treating the DFI number itself. I would typically have him evaluated by a reproductive urologist for a clinical varicocele, recent fever/illness, excessive heat exposure, obesity/metabolic issues, smoking/marijuana, heavy alcohol use, medications, genital-tract inflammation/infection, and prolonged abstinence. Depending on the situation, treatment may include varicocele repair when a clinically significant varicocele is present, treating a documented infection, improving sleep/diet/exercise and reducing heat/toxin exposures, and sometimes a 3-month trial of a good sperm supplement with CoQ10, L-carnitine, vitamins C/E, zinc or selenium. Another surprisingly useful strategy in some men is more frequent ejaculation/shorter abstinence, because sperm sitting in the epididymis longer can accumulate oxidative DNA damage; some fertility specialists use ejaculation every 1–2 days or even a second ejaculate collected a few hours later for IVF/ICSI in selected men with high DFI. I would generally repeat the DFI after roughly 3 months following treatment because that covers approximately one spermatogenic cycle. If fragmentation remains substantially elevated and recurrent pregnancy loss continues, IVF with ICSI may be considered, although ICSI itself does not repair fragmented DNA. In selected couples with persistently high DFI and failed IVF/ICSI or recurrent losses, testicular sperm for ICSI (TESE/TESA-ICSI) can be considered because testicular sperm often have substantially lower DNA fragmentation than ejaculated sperm; however, this is an invasive strategy and the evidence for improved live-birth outcomes is not strong enough to use it routinely as the first treatment. Given your history, if his DFI is elevated, I'd first identify reversible causes and repeat the test before jumping directly to surgical sperm retrieval.
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u/kod2121 Aug 25 '26
Ok got it. I have done some research on this and basically told him to act like he has elevated dna fragmentation, which means I want him to emasculate more frequently and I have him on supplements: COq10, folate, nac, l carnitine,
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u/Regular-Ad-1532 Aug 19 '26
Could be could also be a combination of factors or a different factor. DNA fragmentation is part of my husband l’s issue and now that 3 years have passed since we started ttc egg quality is certainly an issue as well
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u/frogsgoribbit737 Aug 20 '26
I mean... maybe. I lost 3/5 pregnancies and sperm was totally normal in our case. I never got a reason though we suspect it was a clotting issue now. My tests were normal (but barely) and baby aspirin seemed to solve the issue.
Its worth testing to make sure, but i wouldn't bank on it being the problem.
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u/Few_Win_3673 Aug 20 '26
It’s certainly possible, but I wouldn’t assume that DNA fragmentation is the explanation yet.
The fact that you had a healthy pregnancy in 2024 is actually useful context. Sperm DNA fragmentation can vary over time, so a normal semen analysis and a previous successful pregnancy don't necessarily tell you what his current DFI would be.
Given the two recent losses, I don't think testing is unreasonable, particularly since you've already gone through much of the standard RPL workup. But I'd treat the result as one piece of the puzzle rather than a yes/no answer for why you've miscarried. Also, no varicocele on ultrasound is reassuring, but it doesn't rule out every possible cause of elevated fragmentation. Fever/illness, oxidative stress, heat exposure and some lifestyle or medical factors can affect it as well.
I'd be interested to see what the test actually shows before changing anything. If it's elevated, then the useful question becomes why it's elevated and whether there's a treatable factor behind it. And if the DFI comes back normal, that would be useful information too—it would prevent you from chasing DNA fragmentation as the explanation when something else may deserve attention.
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u/kod2121 Aug 25 '26
Ok got it. Thanks so much. I have done some research on this and basically told him to act like he has elevated dna fragmentation, which means I want him to ejaculate more frequently and I have him on supplements: COq10, folate, nac, l carnitine. His dna fragmentation test is next week.
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u/ahwillrockthismic22 Aug 19 '26
Yes I reckon go for it. Also, have you tested vaginal microbiome for ureaplasma, mycoplasma, gardenella etc? If not would recommend as can cause endometritis (localised infection of womb lining which causes inflammation). This is easily treatable with course of antibiotics for you and your partner. Also depending on where you are could maybe look into NK killer cells/immune system as you are planning to do anyway.