Sperm DNA Fragmentation — The Hidden Cause of Unexplained IVF Failure

What is sperm DNA fragmentation? DNA fragmentation index (DFI) measures whether the genetic material inside sperm is damaged or broken (fragmented). Sperm may look completely normal under a microscope and swim perfectly well — yet carry significant DNA damage that prevents healthy embryo development. Why does it matter? High DFI (above 25%) is strongly associated with: - Reduced IVF and ICSI fertilisation rates - Poorer embryo quality and higher fragmentation - Recurrent implantation failure (embryos not sticking) - Recurrent miscarriage (even with good-looking embryos) Causes of high DFI: - Smoking (single biggest cause) - Heat exposure (saunas, hot baths, fever) - Oxidative stress from poor diet and sedentary lifestyle - Varicocele (most common clinical cause) - Infections (prostatitis, epididymitis) - Age (DFI increases with age) - Chemotherapy or radiation How is it treated? - Address root cause — treat varicocele, quit smoking, antioxidants, avoid heat - ICSI with MACS (magnetic activated cell sorting) or PICSI (selecting sperm by hyaluronate binding) selects lower-DFI sperm - Surgical sperm retrieval (TESA) — sperm from the testes have lower DFI than ejaculated sperm in high-DFI cases - Repeat testing after 3 months of lifestyle intervention At Maatritva IVF, DFI testing is recommended for all couples with unexplained IVF failure, recurrent miscarriage, or poor embryo quality despite good semen analysis.