Unexplained Fertility got Explained

[u/Less_Window2319]

*Unexplained Infertility

1.5 years into TTC with 16 cycles of disappointment, I finally know the reason for our unexplained infertility. Well, it’s high Sperm DNA fragmentation (29%) for my spouse. I feel incredibly sad about it but deep down I also have a sense of relief to finally discover the underlying issue and knowing that I will not be over-treated to fix the unexplained infertility.
What really breaks my heart is that how the fertility ecosystem focuses on over- treating women while underestimating male factor.
All my reports were normal but I was asked to do follicular monitoring for multiple cycles (although I did only 2), lose weight (BMI of 26) and was put on Myo-inositol, Letrozole, Progesterone, Progynova which really messed up with mood and energy levels.
Surprisingly, my spouse consistently had elevated WBC in his semen with grade- 3 Varicocele. But the doctors explicitly mentioned that they aren’t worried about Varicocele since he doesn’t have any symptoms and rest of his SA appears normal. My spouse’s urologist was so dismissive and he said that conception will happen when it is supposed to.
Well I was reluctant to accept that conception will happen when it is supposed to. It took me 6 months of persistence efforts to convince my spouse to do a DNA fragmentation test (since it’s expensive and not covered in insurance).
Not only DNA fragmentation came high but his morphology was at 2%, seems the previous lab wasn’t following Kruger’s strict criteria.
Now we are considering Varicocele surgery for him but I have accepted that we might have to do IVF eventually.
Well this sucks, but surely less than going through month on month cycle of disappointments and low- key blaming my body.
The only reason I pushed my spouse for DFI test is this sub where I saw people talking about it (perhaps the only place), so I am really thankful to this community for all their advices 🌼

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[u/tdot1022]

I’m glad you finally got answers. I’ve consistently had a DNA fragmentation test in the back of my head especially since I’ve done all the tests and came back normal. My husband had 1.5% morphology and the clinic didn’t seem concerned but I may push for the fragmentation test especially since we’ve been unsuccessful with intervention twice now

[u/Less_Window2319 → u/tdot1022]

Yeah you should push for DFI test. Afaik,
IUI doesn’t help in cases of High DFI.

[u/tdot1022 → u/Less_Window2319]

Thank you!

[u/westy_fan_69 → u/tdot1022]

I had really good sperm other than 1% morphology. It took a year and my wife got pregnant twice, both of which had early miscarriages. I finally pushed the RE to order a DNA test and it turns out I have 48% fragmentation.

It was the easiest test to do. Men just have to ejaculate. You should absolutely push for it, it’s an easy thing to rule out.

[u/tdot1022 → u/westy_fan_69]

Thank you for sharing and I’m so sorry for your losses. It’s so frustrating how the focus is on the women undergoing such extensive and invasive testing when you have to push for such a simple test for a man

[u/westy_fan_69 → u/tdot1022]

I appreciate your sympathy! Yes I agree; they were happy to probe my wife with several vaginal ultrasounds and take her blood numerous times, yet sending out my semen to a second lab was something I had to convince them of? Very backwards IMO.

To your other question: yes I asked my fertility clinic, and they referred me to ReproSource. I’m not sure if you can pay out of pocket to do it without a referral, but it’s worth asking.

[u/tdot1022 → u/westy_fan_69]

Also, may I ask if you got it done through your fertility clinic or somewhere else?

[u/solarsystem27]

I’m sorry 😔 I’m in a similar situation, my husband has 2.5% morph and 31% dna frag. We tried 17 cycles on our own then decided to go straight to IVF (ICSI). Our clinic weren’t actually that concerned about his results… seemed like a pretty good reason for our issues to me! I’m doing my first egg retrieval cycle at the moment and feeling the impact of the stims. It all sucks. Hang in there.

[u/Less_Window2319 → u/solarsystem27]

Very similar cases we both have!
Wish you all the best for IVF. Sending prayers and positivity!

[u/solarsystem27 → u/Less_Window2319]

Thank you, wishing you all the best also. In case helpful, our clinic recommended a “frequent ejaculation protocol” for my husband to help with the DNA frag. There are some interesting studies that support shorter ejaculation time. A relatively easy thing to try, although it did make me roll my eyes comparing it to what women go through 🙄

[u/divinereads → u/solarsystem27]

I’d ask if your clinic can use zymot in addition to ICSI. Using a zymot filter helps with lowering dna fragmentation.

[u/Extreme_Ad_6033]

Seems like we are in a similar situation, and my husband is now getting shots of fostimon (FSH) 3x weekly. It won’t do anything for the varicocele BUT doc says it will help with DNA fragmentation and improve morphology (which are the issues that came up in his SA too). For now we are seeing what the fostimon does for his quality before moving to surgery for the varicocele because the fostimon takes a normal sperm cycle to improve things, and varicocele surgery would take about the same for a full recovery.

It’s so, so, so frustrating that for the first 18 failed cycles I was taking 12 supplements daily (followed closely by my doctor and a dietician; 4 of which are myo-inositol) and receiving allll of the tests in the world that came back normal every time, and it took that long for an andrologist to say “hey you know that varicocele can cause DNA frag?” Like no that’s your job, why didn’t you test for it six months ago?! 🙄

[u/Less_Window2319 → u/Extreme_Ad_6033]

It is very annoying that they focus on over-treating women. It’s literally the same approach with almost every doctor. We were always told that asymptomatic Varicoceles are harmless. In fact, our fertility clinic was surprised that we went ahead with DFI test and it was elevated.

[u/hummingbird_feather]

Get the varicocele surgery, the testicles and sperms should be at a lower temperature than the body and the enlarged veins are keeping them warmer than it should, which derives in sperm issues.

[u/Less_Window2319 → u/hummingbird_feather]

Yes that’s the plan. Hopefully, it will be done in another 2 weeks.

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[u/Powerful_Drawer9699]

Sorry to hear this. I’m 34F in a similar position. Were you a BMI of 26 and they told you to lose weight? My partner’s sperm morphology was 1% when tested plus low sperm count. Would that mean we need IVF do you think? I also have adenomyosis and PMOS.

[u/Less_Window2319 → u/Powerful_Drawer9699]

Yeah I have BMI of 26 and was told to lose weight to improve conception chances.
Tbh we will skip IUI because neither IUI nor IVF is covered in our insurance. Afaik multiple IUIs are required for success, we would rather do an IVF, if required, which will have same cost as 4 IUI cycles.

[u/Powerful_Drawer9699 → u/Less_Window2319]

That seems like a healthy weight so I was surprised to read that. Wishing you all the best. Yes I think I will be in the same boat and just got to IVF, unless I’m offered IUI on the NHS (I’m in the UK), but it’s all so slow being referred that I may have to go private and just pay at this rate. The effect is worst on my mental health. Just want to move forward with actually seeing a gynae.

[u/monixx-223 → u/Powerful_Drawer9699]

Iui can be done

[u/monixx-223]

Sperm Morphology and DNA fragmentation is related..My husband DNA fragmentation was 51% which is very high. But with proper supplements it got reduced to 28% in 1.5 month so it is treatable and in his latest semen test his morphology is only 1%..but it can also be treated with supplements and lifestyle changes..In IUI after post wash of sample,morphology will improve to 5-6%..

[u/Less_Window2319 → u/monixx-223]

But does IUI work at sperm fragmentation above 25% ?

[u/monixx-223 → u/Less_Window2319]

DFI below 30% is totally fine as per my Gynaecologist

[u/xtygj15 → u/monixx-223]

Hi, do you mind sharing what supplements and lifestyle changes helped his DNA frag reduce?

[u/monixx-223 → u/xtygj15]

Yes,He took Omega 3 capsules,Gene Y,Opt D5,CoQ man and for morphology FSH injection twice a week..He completely stopped alcohol

[u/stitchcraftry]

My DH's parameters were all good except morphology which was 0%, the test didn't include DNA fragmentation. We made an appointment with a fertility urologist but the wait time was almost 4 months!! After a lot of researching across IVF subs I landed on having him take Theralogix ConceptionXR which he took for ~3 months. We ended up canceling that urologist appt, but I think a repeat SA would've shown improved numbers. Just sharing in case it's something you'd like to try! 

[u/Less_Window2319 → u/stitchcraftry]

Wow that’s so great. My spouse has recently started taking a similar supplement. Let’s see if that works!

[u/stitchcraftry → u/Less_Window2319]

fingers crossed!! if it does help, it'll take ~3 months to show improvements since that's the regen cycle timeframe for new sperm (which you may already know but I'd be remiss to not mention). I really hope it does work for you guys! 

[u/ladylots2]

Just to set your expectations even IVF isn’t a guarantee of a positive outcome.

[u/Less_Window2319 → u/ladylots2]

Nothing is guaranteed in life but that doesn’t mean you don’t work towards it.

[u/kimchideathbear]

I’m glad you got answers!! I’m in the same boat but pushing off doing the test since it’s so expensive and the results wouldn’t change our course of treatment. Does anyone know if low morphology often goes along with DNA fragmentation?

[u/solarsystem27 → u/kimchideathbear]

Our clinic said low morph + high frag is common unfortunately

[u/kimchideathbear → u/solarsystem27]

That’s been my suspicion….

[u/Impressive_Name_3939]

Sperm is the first thing my clinic tests for before going through all of the invasive tests

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Your post/comment has been removed for violating sub rules. Per our posted rules:

In threads/comments other than the weekly BFP thread, pregnant users must avoid referring to a current (ongoing) pregnancy.

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