Testing Sperm DNA Fragmentation
The SpermComet test was our first indication that there may be some physiological issue causing our infertility as a couple. We used a clinic in Surrey in England and this test cost £520. This was not a test we had come across ourselves and were only made aware of it by a fertility consultant we had seen for more standard tests. There is more and more evidence available about the comet test but it is not at this time used by the NHS, as the traditional semen analysis is still seen as a more reliable and evidence based marker of sperm health and male fertility. Hopefully the links and information below will summarise what sperm DNA fragmentation is, how it is tested for and what it means for fertility.
Disclaimer: I am obviously not a scientist or specialist in any way, but have gathered information over the course of our fertility journey and through useful online resources.
Fragmentation refers to damage to the double helix structure of the DNA within the sperm. While young, developing sperm can potentially repair some of this damage, by the time the sperm has matured, it is baked in. If DNA is damaged, this can affect the sperm’s ability to reach and fertilise an egg and can affect embryo quality and development if fertilisation is achieved. Current evidence suggests higher levels of sperm DNA fragmentation can lead to lower rates of natural conception and lower rates of success with fertility treatments such as IVF. This Legacy website summarises basically everything there is to know about fragmentation here: https://www.givelegacy.com/sperm-dna-fragmentation/
As with the standard semen analysis, all the actual test consists of for the patient is providing a semen sample to be analysed by a lab, so nothing too invasive to endure, and results take a few weeks to come back. We were sent a comprehensive report via email that summarised what ‘normal’ values are and what our results were against these and it also, helpfully, outlined how the results may affect the outcome of fertility treatments. It should be said at this point, however, that this test is still in its relative infancy and is not enough alone to determine potential pregnancy rates, as outlined in this article: https://progyny.com/education/how-to-test-for-sperm-dna-fragmentation/
Despite me spiralling when we got our less than favourable comet results back, I think the take home as the evidence stands currently is that DNA fragmentation alone doesn’t determine your chances of falling pregnant. Fragmentation is also influenced by lifestyle factors, which can be changed to improve your results. That being said, it can be another useful metric to add to the body of evidence about your fertility and help guide how to proceed. Knowledge is power after all.
