Sperm carry very precious cargo: DNA. Their job is to deliver this DNA to the egg to meet the maternal DNA where two becomes one. A normal semen analysis will look at how good the sperm are at delivering this parcel i.e. how they can swim, how fast they can move. However if the quality of the goods within is compromised, successful conception may not occur.
The Sperm DNA fragmentation test therefore looks at the quality of the DNA within the sperm. Having high levels of DNA fragmentation can be a major cause of ‘unexplained infertility’, recurrent miscarriage and failed IUI or IVF cycles. It can easily be overlooked because high levels of DNA damage can be present even when sperm look normal i.e. you have a completely normal semen analysis.

 

High levels of DNA damage can occur under the following circumstances
– infection, either in or around the testicles (which may have little or no symptoms) or even a bad bout of flu or fever can temporarily cause DNA damage
– varicocele, like a varicose vein in the testicle
– with elevations of testicular heat such as with cycling, heated car seats, working with a laptop on your lap, possibly from carrying a mobile phone in your pocket, use of saunas or Jacuzzis.
– smoking
– increased age
– some medications
– exposure to some chemicals such as in paints, pesticides, or with occupational exposure
– obesity and overweight
– diabetes
– nutritional deficiencies
– genetic inability to use folic acid, such as occurs in up to 20% of the population to a high degree and to a minor degree in up to 40-50%

 

What can be done?
The DNA within sperm can be protected by antioxidants. Certain vitamins and minerals play an essential role here, especially zinc, selenium, vitamin C and vitamin E. Improving your diet by including plenty of fresh vegetables, fruit, nuts and seeds is a good place to start.

Supplements can also be very helpful but it is important to note that over-supplementation can be harmful. Antioxidants are also capable of dampening down some of the energy production that sperm need to swim fast toward an egg and successfully fertilise it. Therefore testing your levels of nutrients is important first and supplementing safely is the best approach.
Here at Glenville Nutrition we have special interest in this field and have published our own research on the topic (see below). We  can organise Sperm DNA fragmentation tests and relevant nutritional tests to personally tailor your treatment plan. DNA fragmentation can be improved in most cases using nutritional and lifestyle changes. Call us on 01-4020777 to find out more or make an appointment.

 

 

Reprod Biomed Online. 2014 Jun;28(6):684-703. doi: 10.1016/j.rbmo.2014.02.004. Epub 2014 Mar 4.

Sperm DNA damage caused by oxidative stress: modifiable clinical, lifestyle and nutritional factors in male infertility.

Wright C¹, Milne S², Leeson H³.

Abstract

DNA fragmentation is an important factor in the aetiology of male infertility. However, it is still underevaluated and its inclusion in routine semen analysis is debated. DNA fragmentation has been shown to be a robust indicator of fertility potential, more so than conventional semen parameters. Men with high DNA fragmentation levels have significantly lower odds of conceiving, naturally or through procedures such as intrauterine insemination and IVF. Couples may be counselled to proceed directly to intracytoplasmic sperm injection as it is more successful in this group, avoiding costly procedures, recurrent failures or pregnancy losses; however, this treatment is not without limitations or risks. Ideally DNA fragmentation should be minimized where possible. Oxidative stress is the major cause of DNA fragmentation in spermatozoa. Endogenous and exogenous factors that contribute to oxidative stress are discussed, and in many cases are shown to be easily modifiable. Antioxidants play a protective role, although a delicate balance of reduction and oxidation is required for essential functions, including fertilization. Reducing oxidative stress may improve a couple’s chances of conception either naturally or via assisted reproduction. Sources of oxidative stress therefore should be thoroughly examined in men with high levels of DNA fragmentation and modified where possible. DNA fragmentation is an important factor in the aetiology of male infertility. However it is still underevaluated and its inclusion in routine semen analysis is still debated. DNA fragmentation has been shown to be a robust indicator of fertility potential, more so than conventional semen parameters. Men with high levels of DNA fragmentation will have significantly lower odds of conceiving naturally or through procedures such as intrauterine insemination and IVF. Intracytoplasmic sperm injection (ICSI) may be much more successful in this group, and couples may be counselled to proceed directly to ICSI, avoiding costly procedures, recurrent failures or pregnancy losses. However, ICSI is not without its limitations or risks. Ideally, DNA fragmentation should be investigated and minimized where possible in men trying to conceive naturally or through assisted reproduction technology. Oxidative stress is the major cause of DNA fragmentation in spermatozoa. Endogenous and exogenous factors that contribute to oxidative stress are discussed and in many cases are easily modifiable. Antioxidants play a protective role, although a delicate balance of reduction and oxidation is required for essential sperm function, including fertilization. Reducing oxidative stress may improve a couple’s chances of conception either naturally or via assisted reproduction treatment. Sources of oxidative stress therefore should be thoroughly examined in men with high levels of DNA fragmentation and modified where possible.

Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

We are very pleased to say that Glenville Nutrition have teamed up with Pomegranate and are offering free nutritional consultations to some Pomegranate couples looking to optimise their fertility. Pomegranate is an Irish charity that supports those suffering from infertility, helping them take a step further towards becoming a parent.

Pomegranate was set up by Fiona McPhillips and Joanna Donnelly, both of whom have been lucky enough to have children thanks to fertility treatment. Fiona is also the author of Trying To Conceive: The Irish Couple’s Guide and the blog, Making Babies. Pomegranate is a symbol of fertility in many cultures and religions.

Fiona has written a guest blog piece for us this week, to share with us some of her story…

Let’s Talk About Infertility

Nobody expects to be in for the long haul when they start trying for a baby. It is supposed to be a time of great hope and anticipation, when you start planning your new lives together. It is true that having a baby changes your life, but not having one changes it so much more. Sadly, this is something that more than one in six couples will find out.
Before I became that statistic, I never thought too much about what it meant. Although infertility was a fear, it was not something that bore heavily on me – at least, only to the extent that I didn’t want to put off having children for too long, just in case. I didn’t know anyone who was infertile so I could only guess at how hard it might be.
I didn’t have a clue. My guess only extended to the long-term pain a couple might feel about not having a child in their lives. Thanks to television, many people assume there is a once-off diagnosis a couple has to deal with, and that they are then free to return to their lives and reshape their future without their much-wanted child. If only it was that easy.
It is very difficult to explain the cumulative effect of month after month, and year after year, of hope and disappointment. After a while, everything hurts – other people’s bumps and babies, anniversaries of failed cycles and lost babies, and every new birthday, Christmas and Mother’s Day you face with empty arms.
There is a huge lack of understanding of infertility in the outside world. It is just not viewed as one of the very bad things in life. A common reaction is, “Why can’t you be happy with what you’ve got? Focus on all the good things in your life”. When you can’t have a baby, nothing else matters. It’s not possible to forget about it, channel your energy elsewhere, take up a hobby. The desire for a child goes beyond the desire for the joy that a child brings – it is a primal, uncontainable urge that overpowers all reason.
Infertility is a very difficult and painful struggle. The research of Dr Alice Domar, professor at Harvard Medical School, suggests that the stress endured by infertility patients is comparable to that experienced by people undergoing treatment for cancer and Aids.
Sometimes this stress can be compounded by people with the best of intentions. “Don’t worry, it could be worse.” “It’s God’s will.” And the old chestnut: “Just relax and it will happen.” If there is one piece of advice I can give to those who know someone suffering from infertility, it is that it is better to say nothing at all than to say the wrong thing. If you feel awkward, just say sorry, and give the person a hug if you think it is appropriate. And one more thing, if I may: stress does not, I repeat, does not cause infertility, but infertility sure does cause stress.
Unfortunately, it’s not just emotional, physical and mental stress – there can also be a huge financial burden. At up to €6000 a go, and with less than a 25% success rate, IVF can become very costly. And for those who don’t have a spare few grand, a diagnosis is often the end of the line.
I know what some of you are thinking: the world is overpopulated already, so many unwanted children out there, why don’t you “just adopt”? Setting aside the huge amount of time and money needed to adopt, I always wonder why the burden of looking after the world’s orphans falls on the shoulders of the infertile. What about those who’ve already experienced the miracle of pregnancy and birth – why don’t they adopt instead of having, say, a second or third pregnancy?
Others may be concerned about the embryos that don’t make it through the IVF process. Even with a “natural” conception, only 20-40pc of embryos make it to implantation. Life may or may not begin at fertilisation but viable life does not begin until the fertilised egg has implanted in the uterus. There is nothing that can be done to protect an unimplanted embryo – you can give it a right to life in law but unfortunately science cannot give any such guarantees.
With one in six couples seeking help to conceive, everybody knows somebody suffering from infertility. It’s an issue that touches all of us either directly or indirectly. And yet it is a conversation many of us have never had.

– Fiona McPhillips, co-founder Pomegranate

We had a great night in Donnybrook Fair last night. We made a selection of delicious and simple recipes to introduce some healthy alternatives, great snacks and salads and some not-so-naughty treats too!
The class got up and got their hands dirty too, making some fragrant fish ‘en papilotte’ with fennel, green beans and spring onions. After working up a nice appetite we all tasted the fruits of our labour which seemed to go down pretty well!
Just to give you at home a flavour, we thought we would share with you one of the popular recipes from last night. This is an extremely easy bread recipe that takes less than ten minutes to put together. A great tip from Heather Leeson is to make the dry mixture up in advance, in a large quantity. This will store nicely in a cool dark place and then all you need to do to make fresh bread is add liquid, stir and bake! What could be easier than that?!
For this simple bread, you can use a variety of flours. Here we use a lovely wholegrain rye mixed with spelt flour for a high fibre wholegrain bread. We add some oats for extra texture and fibre, and handfuls of seeds but you can add whatever you like such as chopped walnuts or milled flaxseeds.
Enjoy!

Spelt and rye soda bread
Preparation time 5 minutes, baking time 50 minutes

Ingredients:

2 cups rye flour
1 ½ cups wholegrain spelt flour
1 cup oat flakes
Large pinch sea salt
1 tsp. bread soda
Handful seeds
420 – 450ml buttermilk

Directions:
• Preheat oven to 200C, grease a bread tin
• Place all dry ingredients together in a large bowl and mix.
• Pour in milk and mix well. Then pour mix into bread tin, scatter seeds or oats on top and bake for 50 minutes

You can replace the butter milk with ordinary milk or dairy free alternatives. If you do, add ½ tbsp. lemon juice too

Obesity and overweight can reduce your chances of conceiving, either naturally or via assisted reproduction such as IVF. In addition, obese women and their children are at a higher risk for complications during pregnancy and beyond.

A new study published by Dr. Kyra Sim from the Boden Institute in Sydney provides good evidence that weight loss can improve fertility outcomes. Dr. Sim and her team recruited 49 obese women who were then randomised to a weight loss programme. Half of the women underwent supervised weight loss in a group support programme with weekly meetings for advice and encouragement. The other half were advised on the same weight loss protocol but had no additional support.

After 12 weeks women in the support group had lost more weight, 6.6 kg (~1 stone) versus only 1.6kg (3.5 pounds) in those that had no support. After 12 months, the women from the group had achieved more pregnancies and live births after assisted conception and indeed 3 natural conceptions. After completing the supervised group programme, the women were 5 times more likely to have given birth to a healthy baby.

The study suggested that “group treatment methods tend to be more beneficial than individual treatment programmes because of factors including group support and cohesion, realization that an individual’s problems are not unique, the sharing of difficulties with other group members, encouragement from others and a group expectation of a positive outcome”

If you are looking to lose weight or are concerned about the effects of being overweight on your fertility, talk to us on 01-4020777.

 

 

Read the study summary:

Clin Obes. 2014 Apr;4(2):61-8. doi: 10.1111/cob.12048. Epub 2014 Feb 28.

Weight loss improves reproductive outcomes in obese women undergoing fertility treatment: a randomized controlled trial.

Sim KA¹, Dezarnaulds GM, Denyer GS, Skilton MR, Caterson ID.

Author information

• ¹The Boden Institute, The University of Sydney, Sydney, NSW, Australia.

Abstract

For women attempting pregnancy, obesity reduces fertility and is an independent risk factor for obstetric and neonatal complications. The aim of this evaluator-blinded, randomized controlled trial was to evaluate a weight loss intervention on pregnancy rates in obese women undertaking fertility treatment. Forty-nine obese women, aged ≤37 years, presenting for fertility treatment were randomized to either a 12-week intervention (n = 27) consisting of a very-low-energy diet for the initial 6 weeks followed by a hypocaloric diet, combined with a weekly group multidisciplinary programme; or a control group (n = 22) who received recommendations for weight loss and the same printed material as the intervention. Anthropometric and reproductive parameters were measured at baseline and at 12 weeks. The 22 women who completed the intervention had greater anthropometric changes (-6.6 ± 4.6 kg and -8.7 ± 5.6 cm vs. -1.6 ± 3.6 kg and -0.6 ± 6.3 cm) compared with the control group (n = 17; P < 0.001). The intervention group achieved a pregnancy rate of 48% compared with 14% (P = 0.007), took a mean two fertility treatment cycles to achieve each pregnancy compared with four in the control group (P = 0.002), and had a marked increase in the number of live births (44% vs. 14%; P = 0.02). A group weight loss programme, incorporating dietary, exercise and behavioural components, is associated with a significant improvement in pregnancy rates and live births in a group of obese women undergoing fertility treatment.

© 2014 The Authors; Clinical Obesity © 2014 International Association for the Study of Obesity