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  1. #1
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    Default Male Factor Infertility and DNA Fragmentation

    Hi all,

    I am hoping someone in bubhub world can help me out. We are undergoing IVF/ICSI to conceive our second child with very little success.

    After our most recent round of IVF that was an unmitigated disaster (of 19 eggs only blastocyst could be transferred and resulted in another miscarriage) my FS has sent my DP of for analysis of his sperm for DNA fragmentation. We have had 5 miscarriages (at various stages before 12 weeks), 4 BFN and have one miracle two year old. Our last cycle clearly indicated that most of our embryos arrest on Day 3. I have been tested for everything under the sun and no issues have been identified.

    I have done some reading in DNA fragmentation and it seems to describe our situation and failures perfectly. I guess I'm hoping for some success stories from couples that have bad DNA fragmentation and what approach was taken for treatment - varicocele surgery, oral anti-oxidents, TESA or any other approach. DP has an appointment next week.

    I am not opposed to using a sperm donor but would like to explore all options before going down that path.

    Any advice, information or thoughts would be greatly appreciated.

  2. #2
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    I have read that if embryos fail to progress beyond day 3, it is usually the sperm's issues. Ours is low rate of fertilsation but we do get to day 5 with those fertilised but never BFP after 3 cycles.

    My DH has MFI too but we so far have tried ICSI+HA (which i think is PICSI) but we have not tried TESA or digital sperm magnification. We are looking into doing SCSA soon and the magnification technique.

  3. #3
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    Hi aloe vera,
    Sorry to hear about your frustrating IVF journey. This is a little unrelated to what you asked, but you mentioned that you had 5 miscarriages. Have you and your DH done a karyotype blood test? I only ask as that gave us the answer as to why most of our embryos weren't progressing past day 3. My DH has a balanced translocation. It's unlikely that either of you will have a chromosome problem, but it's worth doing if you have explored everything else Unfortunately we were the 1/250 couple that have this issue! Many of the chromosome problems like my DH's will cause no problems to the carrier, except difficulty conceiving and possibly multiple miscarriages...
    Good luck.
    Vesper

  4. #4
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    Hi Vesper and MomtoOneDS,
    Thanks for taking the time to reply! I really appreciate it and a big congratulations on your pregnancy Vesper!

    Vesper, I have had karotyping done (plus all other tests) after our twin miscarriage but DP is having his done in January. Can I ask how you and your DH overcame the translocation issue? Was it ISCI with PGD? I must be nice to have a diagnosis to explain the frustrations of before.

    Mom2OneDS, we definitely have sperm issues. Our last cycle started with 19 great quality eggs and resulted in only one blastocyst being transferred and none to freeze. The vast majority of our embryos arrest on day 3. Our previous cycle as a day 2 transfer so we could not see this pattern of arrest but the miscarriages and failures now make sense. Our DS was a FET blastocyst transfer but was conceived in 2008 (born in 2009) so it seems that DP's sperm quality has deteriorated over time. When is your SCSA? Can you tell me more about the magnification technique?

    Again, thanks for the reply...it's lovely to have a chat with people that understand

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    Aloe vera- Because we had so many embies turn to poor quality by day 3 we didn't do PGD as it was pointless paying $3000 to only test one or two embies and our FS was worried about unnecessary damage with biopsy. So we just kept going and wishing and hoping! DH's dad has the same translocation, so we knew that theoretically it could happen. My last cycle we got 16 eggs, 15 fertilised with ICSI, 10 embies at day 3 but only one good quality blastocyst left by day 5! That blastie was our golden embie

  6. #6
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    Aloe vera - firstly sorry to hear you are going through this
    We have had about 16 or so cycles (I've done so many I've lost count!) and always had poor fertilisation rates, sometimes none would fertilise, when they did they would almost never make it to 5 day transfer.
    We asked for a SCSA test and DHs sperm fragmentation came back quite high at around 28%. We asked for a cycle with a high resolution microscope and they embryologists said they struggled to find enough good ones to use, and again we got terrible results.
    We were told it was an egg issue and put on a million things to help improve my apparent egg issue but nothing helped. Finally PICSI (same as HA-ICSI came out and FS said it wouldn't help but I insisted on doing it. We had 15 mature eggs and 11 fertilised. Around 5 made it to blast I think, of varying grades, 2 transferred and I am pregnant for the first time ever.
    So there may be an egg issue too but the DNA frag was definitely holding us back and was the main issue for us. FS usually say if you're under 30% frag don't worry about it but this certainly wasn't the case for us.
    Btw we did try a Tesa cycle but it didn't really help that much for us.
    Good luck and even though every situation is different I'm happy to help if I can, I heard about PICSI from bubhub and wouldn't be pregnant without it.

  7. #7
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    Aloe vera, I am in Melbourne and just found out that MIVF does the sperm magnification, so I may try a cycle with them in Jan but I will need to see a MIVF FS on the 11 Jan first to confirm all these. Sperm magnification is magnifying the sperm up to 7000X and it is claimed to be able to check for DNA abnormalities. DH will probably do an SCSA mid Jan after seeing the new FS. I am not sure if this technique will work for us. PICSI/HA-binding did not help us twice for our last two cyles, unlike for Haydos1979.

    For the last two cycles, I had 11 MII eggs retrieved each time and embryologist always said they look normal (which honestly is very vague and will never be able to know if they were chromosomally fine). If your eggs have dark patches or if they are really abnormal, embryologists can see that but even normal looking eggs can be abnormal. DH's sperm count is low but 4-5 million isnt too bad and I am sure they are able to find good sperm out of that! So I sort of concluded that the problem could be due to egg quality. Anyway we will proceed with SCSA to eliminate all possiblities. I had my lap/hyst done mid this month and so far so good, no endo...that is to rule out implantation issues.

    We have started taking Vit C (2000mg a day) tablets to see see if that helps improve DNA damage.

  8. #8
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    Thanks for all these posts. My DH has had 2 DNA frag tests, one at 62% and the next one at 38% after taking anti oxidants and other things to help. We have just had our 7th failed cycle... I am giving up hope.. We have his brother who has donated sperm but obviously the best outcome is our own child... We haven't even had 1 miscarriage and on our last cycle of PICSI we got our first A grade blast but of course we still didn't get pregnant... any hope for us or is it time to move on (thats our thoughts)
    Is anyone else dealing with this DNA frag issue now?
    Did anyone decide to move on to sperm donor?
    Thanks in advance =)

  9. #9
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    Hi Top Deck, it's a tough call as you don't know what will happen.
    How much better was the last cycle?

    For us we had never had a single frostie in about 17 cycles and had never been pregnant before either. Our cycles were really poor in terms of fertilisation. The PICSI cycle was our best ever but we still had none good enough to freeze. We were lucky enough to get pregnant that cycle but if we hadn't the results were still improved enough to justify trying again.
    There are no guarantees though and we did a massive number of cycles so would jump at even a chance of getting pregnant. If you never had such a good blast before it may be worth trying again but it's a gamble either way.
    I personally would try once more if there was a huge improvement but you have to do what's right for you.
    Good luck and let us know how you go!

  10. #10
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    Hi Mom2TwoDSs, we have MFI too. Can I ask did you try SCSA and the magnification technique to have BFP? Which clinic and dr does the technique? Thank you.


 

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