Real effect of male fertility test to be examined

Irish Examiner  

By Catherine Shanahan

Whether an expensive male fertility test has any bearing on improving outcomes for couples with difficulties conceiving is being examined as part of a project at Waterstone Clinic (CFC).

 The sperm DNA fragmentation test, which examines the level of damaged DNA found inside the sperm head, costs, on average, €400, and is offered by many fertility clinics.

However, whether these tests have any real value should become clearer when scientists involved in the DNA Fragmentation Trial at CFC determine if excessive sperm DNA fragmentation really precludes conception naturally.

Dr John Waterstone, medical director of CFC, said he was “alarmed by the lack of evidence” in relation to the usefulness of sperm DNA fragmentation tests and for “the recommendations generated by the results”.

Dr Waterstone said the reproducibility of some of the tests being used seems poor.

“We have had male patients who have had two tests, one of which has shown a high DFI and the other a low DFI (DNA fragmentation index).

“If results are not reproducible (the same in separate tests) how can recommendations be made?” Dr Waterstone said.

Even if results were reproducible, Dr Waterstone said there was “insufficient evidence that DFI levels should determine the urgency of fertility treatment or the form of treatment recommended”.

“The worry is that patients who would have conceived naturally, if only they had been given sufficient time, may be subjected to expensive sperm DNA tests and then pushed into expensive unnecessary treatment. The value of sperm DFI tests needs to be studied in order to protect patients,” said Dr Waterstone.

CFC in collaboration with Cork University Maternity Hospital began their research project 18 months ago. In order to complete it, they need more couples to take part.

Research scientist Dr Julie O’Callaghan said only couples with unexplained fertility issues were eligible for the trial which involves carrying out (free of charge) two different tests of DNA fragmentation when eligible couples first attend the centre. Eligible couples can have basic Semen Analysis (a test which measures the volume of sperm produced on ejaculation, as well as the sperm count (number of millions of sperms per ml of semen) and motility (percentage of sperm in the sample that are moving) and the morphology (percentage with normal shape), together with two sperm DNA fragmentation tests all carried out free of charge; they can then, if they wish, avail of up to three IUI treatment cycles carried out at a greatly reduced cost.

Medical director of the Merrion Clinic in Dublin, Dr Mary Wingfield, said she “delighted” the research was being done. “There are lots of tests out there that are not proven, infertile couples are desperate, they are a very, very vulnerable group, I think a lot of us feel anything we do has to be justified.

Data collected during the trial will be coded and anonymity maintained. Anyone interested in taking part can email [email protected] or phone 021 4865764