Male Fertility

Sperm DNA Fragmentation Assay (SDFA)

Sperm DNA Fragmentation Assay may be a useful test in couples with male factor or unexplained infertility who are trying to decide whether to undergo superovulation with insemination or in- vitro- fertilization with ICSI (sperm injection).

Background: Traditional sperm fertility tests, like the semen analysis, are poor predictors of the ability of sperm to fertilize an egg. Infertility specialists are continually looking for a test that would improve the predictability of the semen analysis. Other testing like strict morphology, hamster penestration assay, and zona binding tests are helpful but lack excellent predictability. Over the last several years SDFA was introduced to determine the ability of ones sperm to fertilize his partner’s egg. SDFA is a marker of DNA fragmentation in sperm. High percentages of fragmentation are associated with a low chance of conceiving spontaneously or with superovulation and insemination. Fortunately, Dr. Couchman, while at Duke, coauthored a paper that showed that SDFA levels did not correlate with success once the couple underwent IVF.  Although the article was helpful for IVF it did not address the issue on whether IVF is a better choice than superovulation/IUI based on the SDFA results.

What we know now: An article by Bungum, published in Human Reproduction 2007 suggests that the SDFA may be helpful in this decision. They reported that of couples that had high levels of DNA fragmentation (ie> 30%) only 1.5% delivered a baby using IUI, while couples with highly fragmented chromatin who did IVF with ICSI had a 24% delivery rate, suggesting SDFA may be a useful tool in determining whether IVF should be pursued immediately or whether it is reasonable to try superovulation with insemination.

What this tells us: Although this is only one study, it did encompass over 1000 cycles. This may prove to be a very useful tool to assist couples who are contemplating superovulation IUI or IVF. 

How to order:  Call Carolina Conceptions at 919-782-5911 to schedule a Thursday Morning appointment for this assay.  Please make sure that you are between 2-3 days abstinent( last ejaculation on Monday).  If you are longer than 3 days, the assay may be compromised.

Costs: The total fee for the assay that Repromedix performs is $400.  If you have insurance coverage, Repromedix will collect $100 from you.  If your insurance pays the full $400, a refund will be issued to you.  If you do not have insurance coverage, you will be liable for the $400 charge.  Repromedix is in-network with Blue Cross Blue Shield and will not accept Medicare or Medicaid.  At the time of service, you will be expected to pay a processing fee of $125 to Carolina Conceptions.  Your insurance company will NOT be billed for this fee.