The overlooked role of sperm DNA damage in recurrent miscarriage

Sperm health may play a more significant role in recurrent miscarriage than previously thought, according to new recommendations spotlighting sperm's role in the issue. While standard tests measure sperm count and motility, these tests only show how likely sperm are to reach the egg, not the subsequent steps needed for a successful pregnancy. Even after conception, problems with sperm can interfere with pregnancy.

Research has linked sperm DNA fragmentation, where the genetic information within sperm is broken or damaged, to miscarriage and lower IVF live birth rates. Sperm DNA fragmentation tests have been available for decades, and a recent update to the American Society for Reproductive Medicine's recommendations now includes testing for DNA fragmentation in men, although not for all patients who have experienced recurrent pregnancy loss.

The test can help identify men with high levels of sperm damage, which may be contributing to the issue.

However, there is a disparity between the research and conversation around female infertility issues and those related to sperm. According to freelance science journalist Sarah Elizabeth Richards, men contribute to 50% of infertility problems, with 20% of cases attributed solely to sperm and 30-40% due to a combination of sperm and egg issues.

Despite this, men are often overlooked in discussions and studies surrounding infertility. Cultural shifts, such as the rise of "sperm maxxing" and men taking steps to optimize sperm health, suggest a growing awareness of the importance of sperm health.