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Introduction
Hello, I am Dr. Vaishali Giri, an IVF Specialist and Cosmetic Gynecologist at Sahyadri Hospital, Hadapsar, Pune. Today, I would like to talk about a very important topic – DNA Fragmentation Index (DFI).
What is DNA Fragmentation Index (DFI)?
DFI stands for DNA Fragmentation Index. Let’s understand this in a simple way. In the sperm head, DNA is very compact and complex. After fertilization of the sperm and egg, the sperm provides its genetic material to the egg through DNA, contributing to the baby’s genetics. Normally, DNA doesn’t have cuts or breaks, but sometimes, due to certain reasons, if DNA breaks occur, fragments are formed. We calculate these fragments and call it the DNA Fragmentation Index. This specialized test checks 100-200 sperms to see how many are fragmented or defective. If the percentage of fragmented sperms is more than 25%, it is considered abnormal; below 25% is acceptable.
Causes of High DNA Fragmentation Index
There can be various reasons for high DFI, divided into testicular and non-testicular factors:
Testicular Factors:
Defects in sperm production or conditions like varicocele, affecting the temperature around the testes, can increase DFI.
Non-Testicular Factors:
Lifestyle Factors: Smoking significantly affects semen parameters, making it crucial to stop smoking if DFI is high. Alcohol consumption, especially regular drinking, also impacts sperm parameters and DFI. Overweight patients are advised to have a balanced diet and lose weight. Certain treatments like cancer therapies or hormonal treatments can affect DFI. Age also plays a role; as men age, DFI tends to be higher.
When is DFI Testing Recommended?
DFI testing is crucial when:
All parameters of both partners are normal, but pregnancy is not achieved.
There are repeated IVF failures.
Pregnancies occur but result in miscarriage.
In these situations, DFI testing helps identify if DNA defects are causing pregnancy issues or miscarriages.
Treatment for High DNA Fragmentation Index
To address high DFI, the following steps are recommended:
Lifestyle Modifications: Weight loss, quitting smoking and drinking, maintaining a healthy balanced diet, and regular exercise.
Antioxidants: Taking antioxidants for at least three months to see results.
ICSI Treatment: In cases where DFI remains high despite lifestyle changes, Intracytoplasmic Sperm Injection (ICSI) is suggested. ICSI involves selecting a healthy sperm without defects and fertilizing it with a good-quality egg using a machine. This treatment often helps achieve pregnancy.
