Fertility Treatments

DFI

The DNA Fragmentation Index, or DFI, is a process that can help determine if you have fertility problems by analysing your sperm.

Introduction

Often, the two primary reasons behind male infertility are the quality and quantity of the sperm, which means that either the sperm is of low quality or the sperm count in ejaculate released is lower than usual. But the cause of infertility may also be DNA fragmentation because the issues associated with infertility usually stem from the DNA. So what is DNA fragmentation?

Before moving onto DNA fragmentation, you must know what DNA is? DNA or deoxyribonucleic acid is a material that carries genetic information through the body. It is found in every component of a living being, including the sperm of a man. That’s why, as the name suggests, fragments of DNA may reflect issues in the sperm’s genetic composition.

What Is Sperm DNA Fragmentation?

The amount of genetic damage caused in the sperm’s DNA is sperm DNA fragmentation. The genetic materials are carried from the male to the female body through the powerhouse, sperm. The breakages in the sperm DNA are shown by fragmentation. According to some of the latest pieces of research, one of the most significant causes for male factor infertility is sperm DNA fragmentation. Your partner may suffer a failed pregnancy attempt or even a miscarriage, even though the sperm count and motility and morphology of your sperm are alright. That may be because of your sperm having an abnormal genetic composition. Although certain studies have shown that the egg cells and ovum have the ability to repair the sperm’s DNA fragmentation, the cases of it happening are pretty rare. Also, your sperm’s DNA may be so fragmented that the egg cells can’t repair it. 

Although the experts have not been able to determine the exact cause behind sperm DNA fragmentation, this issue most likely results from defective DNA repair processes or even oxidative stress. Other than that, here are a few of the factors that may lead to sperm DNA fragmentation:

  • Obesity
  • Ageing
  • High fever
  • Drug and alcohol abuse
  • Unhealthy environment
  • Cigarettes

 

Based on the factors stated above, it won’t be wrong to infer that the DNA of your sperm is most likely to be affected by your lifestyle choices. But there still is no definite proof behind the effects of these factors on your DNA.

What Is DFI?

The exact cause of male infertility is often undetermined in almost 30% of the cases. The only process that can help determine if you suffer from fertility issues is the semen analysis, which helps account for three characteristics of the sperm: the sperm count, morphology and motility. But no, according to the latest pieces of research, experts suggest that the extent of DNA fragmentation in your sperm can help predict if you suffer from male fertility issues and to what extent. The measurement for DNA fragmentation is referred to as the DNA fragmentation index or DFI. 

Since the fragmentation is in the genetic material or DNA of your sperm, performing just a semen analysis may not be enough to check the abnormalities. So the experts have developed several tests for the same, like SCSA or Sperm Chromatin Structure Analysis, the most common one of them. In the SCSA test, the doctors will make contact between the sperm and a unique chemical dye. After contact, if the DNA turns red, it would mean breakage in the sperm. But if the DNA turns green, it would mean that the sperm is healthy. Afterwards, the doctor will calculate the ratio between healthy and broken sperm with the help of a specialized computer. This ratio is commonly referred to as DFI or DNA fragmentation index. 

The vital factors in determining the motility, morphology and concentration of your sperm are the sperm’s quality and integrity. But, as mentioned earlier, fragmented DNA may result in the sperm being damaged and may also cause subfertility and infertility. So DFI or DNA fragmentation index is an excellent analysis for evaluating the degree of fragmentation in your sperm. This procedure can help you with better and more detailed results than the conventional tests. Breaks in the DNA strand in your sperm may result in abnormal genetic materials, denoted by SDF or sperm DNA fragmentation. SDF may also be due to your body not being able to repair the DNA breaks. 

If you have fragmented DNA in your sperm, it may influence your male fertility potential and embryo development, resulting in miscarriages and failed IVF attempts. Higher DNA fragmentation index may be due to inflammation in the varicocele and external genitals, environmental contamination like pollution and radiation, advanced age, bad lifestyle choices like excessive smoking, drugs and alcohol abuse, etc.

Why Do You Need DFI?

DFI or DNA fragmentation index is a tool opted by the doctors if they suspect infertility or some fertility issues in the male partner. It may be considered a viable choice for the following reasons:

  • Timely diagnosis: Depending upon the integrity of the sperm’s DNA, the DNA fragmentation index or DFI provides you with a clear understanding of your sperm’s functional ability. Having a timely diagnosis of your sperm will help you avert any stress you may have. The doctor will also form a course of treatment for any issues you may be diagnosed with. 
  • Helps avert any issues due to fragmented DNA: With the help of the DNA fragmentation index, the doctor will be able to formulate a treatment plan for you. It will help save you from any issues further down the line due to fragmented sperm. A few of the issues of DNA fragmentation include genetic and chromosomal deformities, miscarriage, failed IVF attempts, etc. 

 

Currently, the diagnosis and assessment for your fertility issues include conventional semen analysis, which involves sperm count, along with motility and morphology of the sperm. But around 15% of the men being diagnosed through traditional semen analysis are still unable to conceive. It means that you can’t completely rely on the semen analysis to assess your fertility issues because it reflects only your sperm’s fertility potential. But DFI can help assess the extent of damage in your sperm’s DNA. If your DFI is more than 30%, there may be a possibility of male infertility.

What Are The Risks Of DFI?

Although there are no risks associated with the DNA fragmentation index that may affect the male partner, there are a few limitations to it:

  • DNA distinction is challenging: Not all DNA in your body serves an objective function. So DFI provides you with an analysis of the fragmentation in your DNA. But it may not help you distinguish between the useful and non-useful fragments of DNA, making the whole process a bit redundant.
  • No Threshold For Fragmentation Index Value: It is well-known that DFI helps differentiate between fragmented and intact DNA. You may also know that the lower the DFI, the more fertile you are, and vice-versa. But the experts have not yet determined the threshold DFI value between fertile and non-fertile. 

 

There will be a possibility of DNA fragmentation even though the count, motility or morphology of your sperm are alright. If you and your partner have experienced failed IVF attempts and miscarriages, you may contact your doctor for a DNA fragmentation Index.

Conclusion

For your natural conception or IVF attempt to result in a successful pregnancy, the integrity of the genetic material or DNA of your sperm is imperative. Sperm DNA fragmentation is a term doctors use to denote the amount of genetic damage caused in the sperm’s DNA. This DNA fragmentation may be a reason behind your infertility, causing failed IVF attempts and even miscarriages. There may be a possibility of DNA fragmentation even though the count, motility or morphology of your sperm are alright. That’s why DFI or DNA fragmentation index is necessary to improve the chances of a successful pregnancy.

Here are a few advantages of DFI:

  • It provides a clinical diagnosis and estimation of treatment for male factor infertility. 
  • It provides a fruitful analysis of the DNA integrity of the sperm to check if you are fertile, subfertile or infertile. 
  • It provides a predictive value for the assessment of ART outcomes. 

 

If you are looking for more information about the DNA fragmentation index or DFI, please consult the Fertility experts at Siya Health, or call our Siya Fertility Counsellor today.

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Dr. Dipesh Sorathiya

M.S. (Obs & Gyn)
DIP. in Gynec Endoscopy (CICE)

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