Sperm DNA damage emerges as key factor in repeated pregnancy loss

Studies have shown that breaks in sperm DNA can contribute to miscarriage and diminish live-birth rates in IVF cycles. In response, the American Society for Reproductive Medicine updated its guidelines to include sperm DNA fragmentation testing for couples experiencing repeated pregnancy loss, but only when uterine and fetal-tissue analyses are inconclusive. The assay, available for several decades, costs between $300 and $500 and requires an additional semen sample.

Clinicians report that simple lifestyle modifications—such as reducing alcohol, improving diet, exercising and taking certain supplements—can lower fragmentation levels. Critics note the delay in offering the test, arguing that early screening could prevent emotional distress and reduce overall treatment costs. The growing conversation also aims to involve men more fully in fertility discussions and lessen stigma surrounding male contributions to infertility.