What is DNA frag­men­ta­tion?

Sperm trans­port pater­nal genet­ic infor­ma­tion to the egg cell. If there are breaks or dam­age in the DNA of the sperm cells, this is referred to as increased DNA frag­men­ta­tion.

An increased pro­por­tion of frag­ment­ed sperm can influ­ence fer­til­iza­tion and ear­ly embry­on­ic devel­op­ment and may be asso­ci­at­ed with a low­er prob­a­bil­i­ty of preg­nan­cy or an increased risk of mis­car­riage.

When is a DNA frag­men­ta­tion test use­ful?

An exam­i­na­tion of sperm DNA can mean­ing­ful­ly sup­ple­ment fer­til­i­ty diag­nos­tics in var­i­ous sit­u­a­tions:

Logo Ikon In cas­es of unful­filled desire to have chil­dren despite an incon­spic­u­ous spermiogram

Increased DNA frag­men­ta­tion can be present in both an abnor­mal and an incon­spic­u­ous spermiogram. Espe­cial­ly when no preg­nan­cy occurs despite large­ly incon­spic­u­ous stan­dard diag­nos­tics, the exam­i­na­tion can pro­vide addi­tion­al infor­ma­tion, as DNA dam­age is not vis­i­ble in a clas­sic spermiogram.

Logo Ikon In cas­es of unsuc­cess­ful IVF/ICSI treat­ments

If sev­er­al fer­til­i­ty treat­ments have remained unsuc­cess­ful, increased DNA frag­men­ta­tion of the sperm may be a pos­si­ble con­tribut­ing cause. The exam­i­na­tion can help to fur­ther assess sperm qual­i­ty.

Logo Ikon In cas­es of repeat­ed mis­car­riages

The exam­i­na­tion of sperm DNA can also be use­ful in cas­es of repeat­ed mis­car­riages. Increased DNA frag­men­ta­tion is asso­ci­at­ed with impaired ear­ly embry­on­ic devel­op­ment and an increased risk of mis­car­riage.

Logo Ikon In the pres­ence of cer­tain risk fac­tors


For exam­ple, in the case of a varic­o­cele, high­er pater­nal age, inflam­ma­tion, or sig­nif­i­cant­ly restrict­ed sperm qual­i­ty, a DNA frag­men­ta­tion analy­sis can also be use­ful.

Pos­si­ble caus­es of increased sperm DNA frag­men­ta­tion

DNA dam­age to sperm can be pro­mot­ed by var­i­ous fac­tors. These include:

  • Smok­ing and reg­u­lar high alco­hol con­sump­tion
  • Vari­cose veins in the tes­ti­cles (varic­o­cele)
  • Advanced age
  • Infec­tions and inflam­ma­tion of the gen­i­tal tract
  • Obe­si­ty and meta­bol­ic dis­eases
  • Heat and cer­tain envi­ron­men­tal expo­sures
  • Chron­ic stress and per­sis­tent lack of sleep
  • Cer­tain med­ica­tions as well as pre­vi­ous chemother­a­py or radi­a­tion ther­a­py

Many of these fac­tors can increase oxida­tive stress. This pro­duces more reac­tive oxy­gen com­pounds, which can dam­age the DNA of the sperm, among oth­er things. How­ev­er, a clear cause can­not always be found. Often, sev­er­al fac­tors act togeth­er. A tar­get­ed clar­i­fi­ca­tion can help to iden­ti­fy pos­si­ble treat­able or influ­ence­able caus­es.

How sig­nif­i­cant are DNA frag­men­ta­tion tests?

The DNA frag­men­ta­tion test pro­vides addi­tion­al infor­ma­tion about the qual­i­ty of the sperm but should always be assessed in con­nec­tion with the oth­er find­ings.

  • The test com­ple­ments the clas­sic spermiogram but does not replace it.
  • The assess­ment of DNA frag­men­ta­tion depends, among oth­er things, on the test pro­ce­dure used; the lim­it val­ues may there­fore dif­fer.

An increased val­ue does not mean that a nat­ur­al preg­nan­cy is impos­si­ble.

How the DNA frag­men­ta­tion test works

The DNA frag­men­ta­tion test can be car­ried out eas­i­ly using a semen sam­ple. The results are then eval­u­at­ed by our doc­tors and cat­e­go­rized togeth­er with the spermiogram and your per­son­al fer­til­i­ty his­to­ry.

  1. Sub­mis­sion of the semen sam­ple

    The semen sam­ple can be sub­mit­ted dis­creet­ly and in a calm atmos­phere direct­ly at our fer­til­i­ty cen­ter in Munich. Alter­na­tive­ly, by pri­or arrange­ment, it can also be obtained at home and brought to our lab­o­ra­to­ry with­in 40 min­utes while kept at body tem­per­a­ture.

    Make an appoint­ment

  2. Prepa­ra­tion and analy­sis in the lab­o­ra­to­ry

    The sam­ple is exam­ined in our lab­o­ra­to­ry using the HaloSperm® test. This is a so-called SCD test (Sperm Chro­matin Dis­per­sion Test), which is used to deter­mine the pro­por­tion of sperm with frag­ment­ed DNA.

  3. Med­ical clas­si­fi­ca­tion of the results

    Our doc­tors clas­si­fy the result togeth­er with the spermiogram, your med­ical his­to­ry, and your pre­vi­ous fer­til­i­ty jour­ney.

    In the case of abnor­mal val­ues, we will dis­cuss pos­si­ble caus­es and sen­si­ble fur­ther steps with you.

  4. Dis­cus­sion of the next steps

    In the case of increased DNA frag­men­ta­tion val­ues, we will dis­cuss pos­si­ble caus­es with you and which fur­ther exam­i­na­tions or treat­ment options may be use­ful in your per­son­al sit­u­a­tion.


What does increased DNA frag­men­ta­tion mean?

Per­son­alised pro­ce­dure

An increased pro­por­tion of sperm with frag­ment­ed DNA can impair male fer­til­i­ty. Increased DNA frag­men­ta­tion can reduce the chances of preg­nan­cy and a suc­cess­ful course of preg­nan­cy. Fer­til­iza­tion and ear­ly embry­on­ic devel­op­ment can also be impaired, and the risk of mis­car­riage may be increased. How­ev­er, an increased val­ue does not mean that a nat­ur­al preg­nan­cy is impos­si­ble.

In the case of an abnor­mal result, we first look for pos­si­ble caus­es. These include, for exam­ple, a varic­o­cele, infec­tions or inflam­ma­tion, as well as lifestyle and meta­bol­ic fac­tors. Oxida­tive stress often plays an impor­tant role. Treat­able or influ­ence­able caus­es should there­fore be addressed as specif­i­cal­ly as pos­si­ble.

Since the for­ma­tion and mat­u­ra­tion of new sperm takes sev­er­al weeks, changes in sperm qual­i­ty can become appar­ent with­in about two to three months. A fol­low-up exam­i­na­tion may then be use­ful.

In the case of increased DNA frag­men­ta­tion, we will dis­cuss with you which fur­ther diag­nos­tic exam­i­na­tions and tar­get­ed mea­sures are use­ful in your per­son­al sit­u­a­tion.

What can be done about increased DNA frag­men­ta­tion?

Which mea­sures are use­ful depends on the cause, the extent of the DNA frag­men­ta­tion, and your pre­vi­ous fer­til­i­ty his­to­ry. Togeth­er with you, we will decide which next steps are sen­si­ble in your per­son­al sit­u­a­tion.

IDENTIFYING TREATABLE CAUSES

In the case of increased DNA frag­men­ta­tion, we first check for pos­si­ble treat­able or influ­ence­able caus­es. These include, for exam­ple, a varic­o­cele, inflam­ma­tion, or hor­mon­al abnor­mal­i­ties. If nec­es­sary, we rec­om­mend a sup­ple­men­tary
andro­log­i­cal clar­i­fi­ca­tion. We also include lifestyle and meta­bol­ic fac­tors in the assess­ment.

Antiox­i­dant ther­a­py and fol­low-up

Since oxida­tive stress is often involved in DNA dam­age, tar­get­ed antiox­i­dant sup­ple­men­ta­tion may be use­ful in select­ed cas­es. After about three months, we check the DNA frag­men­ta­tion again if nec­es­sary to be able to assess pos­si­ble changes. The cur­rent state of research shows pos­si­ble improve­ments, but is not con­sis­tent in all stud­ies.

Opti­mized sperm selec­tion in fer­til­i­ty treat­ments

In the case of insem­i­na­tion (IUI) or ICSI, we can pre­pare and select the sperm before fer­til­iza­tion using spe­cial pro­ce­dures. For this pur­pose, we use, among oth­er things, microflu­idic sperm selec­tion with the ZyMōt® cham­ber.

In this process, par­tic­u­lar­ly motile sperm migrate through fine microchan­nels and are select­ed par­tic­u­lar­ly gen­tly. Sperm with DNA dam­age are there­fore sig­nif­i­cant­ly less com­mon in the select­ed sperm pop­u­la­tion. Stud­ies show that sperm obtained using microflu­idic meth­ods have, on aver­age, low­er DNA frag­men­ta­tion.

The select­ed sperm can then be used for insem­i­na­tion, IVF, or ICSI, depend­ing on your indi­vid­ual treat­ment.

TESE for increased DNA frag­men­ta­tion

In cas­es of sig­nif­i­cant­ly increased and repeat­ed­ly con­firmed DNA frag­men­ta­tion, the retrieval of sperm direct­ly from the tes­ti­cles can be con­sid­ered in spe­cial sit­u­a­tions. Tes­tic­u­lar sperm may have low­er DNA frag­men­ta­tion than sperm from the ejac­u­late in some men.

Since this requires an inva­sive pro­ce­dure, we do not use this method rou­tine­ly for increased DNA frag­men­ta­tion, but only dis­cuss it in select­ed cas­es after care­ful indi­vid­ual con­sid­er­a­tion.

Close-up of a flower vase in the bright practice atmosphere at the fertility center in Munich for a relaxed consultation.

Why have the DNA frag­men­ta­tion analy­sis per­formed with us in Munich

Arrange a con­sul­ta­tion appoint­ment

  • Spe­cial­ized sperm diag­nos­tics

    We exam­ine DNA frag­men­ta­tion direct­ly in our own androl­o­gy lab­o­ra­to­ry using the HaloSperm® test (SCD test) and can com­bine the find­ings with your spermiogram and fur­ther exam­i­na­tions of sperm qual­i­ty.

  • Per­son­al Med­ical Clas­si­fi­ca­tion

    A DNA frag­men­ta­tion val­ue alone does not tell the whole sto­ry about your fer­til­i­ty. Our doc­tors assess the result togeth­er with your spermiogram, your med­ical his­to­ry, and your pre­vi­ous fer­til­i­ty jour­ney and dis­cuss the find­ings with you per­son­al­ly.

  • Diag­nos­tics and treat­ment from a sin­gle source

    If DNA frag­men­ta­tion is increased, we check pos­si­ble caus­es and dis­cuss spe­cif­ic next steps – from an andro­log­i­cal clar­i­fi­ca­tion and influ­ence­able lifestyle fac­tors to spe­cial sperm selec­tion pro­ce­dures such as ZyMōt® dur­ing fer­til­i­ty treat­ment.

  • Short dis­tances in Munich

    Exam­i­na­tion, lab­o­ra­to­ry analy­sis, and med­ical advice are close­ly coor­di­nat­ed with us. Our fer­til­i­ty cen­ter is cen­tral­ly locat­ed in Munich city cen­ter. 

 
  
 
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What Our Patients Say

 
 
 
 
 
 
 
 
 
 
 
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 Sandra B 
 
105 days ago
 
 
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Had a very good experience, I felt very well taken care of, everyone very professional, standardized routines, can definitely recommend
  
 
 
 
 
 
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 Lauren W 
 
141 days ago
 
 
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We flew from overseas to work with Dr Mann and her team. Everyone was so kind, empathetic and extremely helpful. Everyone spoke English and made us feel very welcome. We could not have asked for better care than what we received from Dr Mann and her team. Bonus, the offices are beautiful.
  
 
 
 
 
 
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 Andrea C 
 
185 days ago
 
 
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After visiting two other fertility clinics (one of which I left in tears), I had almost lost hope of finding a place where I would truly feel heard. Then I met Dr. Sarah Comploj, and everything changed.

From the very first consultation, I felt genuinely listened to and treated as an individual. Unlike my previous experiences, where I was quickly told I needed IVF without anyone really taking the time to understand my situation or carefully review my test results, here I felt that my case truly mattered. Every step was explained thoughtfully, and my concerns were taken seriously.

What stood out the most was that I never felt like just another patient or that the focus was on money. Instead, I felt that the entire team was committed to helping me achieve my dream in the most appropriate and personal way possible.

Today, I am holding my one-month-old baby in my arms, and I will forever be grateful for the care, compassion, and expertise I received here. I can only highly recommend this clinic and Dr. Comploj 🩷
  
 
 
 
 
 
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 Viktoria O 
 
323 days ago
 
 
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Every appointment I’ve had over the last few months has been consistently informative, professional, and conducted in a personal manner. The treatment plan was explained in detail and any concerns or questions always answered. She also speaks perfect English if required. I’m impressed with how well organised the clinic is and how quickly results are processed, and last-minute appointments made available. For anyone who is going through the struggle of infertility it’s a difficult and vulnerable time, but I always felt so reassured and in good hands with Dr Mann.
  
 
 
 
 
 
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 Local R 
 
331 days ago
 
 
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A heartfelt thank you to Dr. Gerber for the exceptional support and warmth during a very sensitive journey. I always felt respected and in good hands. Truly grateful.
  
 
 
 
 
 
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 V D 
 
452 days ago
 
 
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I'm very grateful for my experience, the staff from reception to the doctors were very kind. You can feel  accompanied during the treatment. Also, overall I had a successful treatment, especially considering my age, it's a costly treatment but it's worth it. So I'm very happy for the result, my doctor was Sara Comploj.
  
 
 
 
 
 
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 Marina 
 
489 days ago
 
 
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I had a wonderful experience with the Kinderwunsch practice, and especially with dr. Corina Mann. From the very beginning, dr Mann was attentive, knowledgeable, and truly invested in helping me achieve the best possible outcome. She took the time to understand my goals and tailored my treatment plan to make sure I had the best chance of success.

Thanks to her care and expertise, I was able to maximise my results and reach my goals. I always felt supported, informed, and in the best hands. Dr Mann always answered my countless questions with a smile :) I’m incredibly grateful for her dedication and would wholeheartedly recommend her to anyone starting their fertility journey.
  
 
 
 
 
 
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 Carmencita 
 
491 days ago
 
 
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I just want to say a big thank you to the whole team of Dr. Mann and Dr. Albrecht. I felt really taking care off  in this Praxis and really can recommend everyone to go to this clinic, as here you can get at least the most possible personalization and time dedicated to you! Thanks again for your support!
  
 
 
 
 
 
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 Maria K 
 
587 days ago
 
 
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Since my doctor was busy and couldn't do the procedure herself, I had an appointment with Sarah to have my fallopian tubes checked. I was very nervous before the procedure, but it turned out to be for nothing! Sarah described and explained every step of the procedure and was extremely friendly.
  
 
 
 
 
 
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 Jay B 
 
1149 days ago
 
 
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Our multiple years-long Kinderwunsch journey was spent under the care of Dr. Mann and her Kinderwunsch practice team. Dr. Mann is not only a highly competent expert in her field, she's also empathetic and kind. She treated each appointment with a sense of being genuinely invested — listening to concerns or questions, planning for my unique treatment needs, and explaining processes or procedures without rushing (because she knows it's likely your first time going through something ... even though it might be her 40000th time). Her practice is busy and it's because she's the best. The practice team is cheerful and helpful. The waiting area is comfortable with pleasant music, flowers, and they even laid out gingerbread during Christmas time. They have a lab on-site so results are often same-day. I particularly found the technology they use to share results via email quickly so helpful. And I always felt at ease speaking in my native language and not pressured to try to keep up with unfamiliar German terminology. I'm forever grateful to have found Dr. Mann. We plan to visit soon with our new plus-one :)

- RB & JB
  
 
 
 
 
 
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 Aparna P 
 
1649 days ago
 
 
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Dr.Albrecht is really good and friendly. She is best at her own way. But reception staff is very very very worst and disappointing. They themselves book an appointment and say it’s not booked. Luckily in Doctorlib my appointment was visible. Staff is very very rude. And they respond very rudely. I can give 0 rating for Staff at reception.
  
 
 
 
 
 
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 Cindy L 
 
1670 days ago
 
 
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We had an absolutely wonderful experience with Dr. Mann. Her positive energy and competence was so reassuring and much appreciated during the potentially stressful time of trying to have a baby. I really loved how we could communicate in either English or German over complicated and sensitive reproductive matters. She took the time to answer all of our questions and offered us a wealth of information regarding the treatments. And her staff brought the same good vibes and Expertise to the practice. Some of the best and painless blood draws I’ve ever had, and they were always very responsive through emails as well as telephone communication. Online appointment system was also great. Video consults super convenient. The setting of the practice itself is an oasis of peace and calmness. As soon as I stepped through the doors I felt relaxed with the music, green plant wall, and well designed and decorated space. Technology and quality of equipment is very good. Yes, sometimes the waiting time had been 30+ minutes, but because the patient care is so excellent, I’ll be back for future treatments as needed, and would highly recommend this practice and team to anyone.
  
 
 
 
 
 
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 Raluca O 
 
1854 days ago
 
 
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I have only the best words to describe my experience at the clinic. I personally worked with Dr. Albrecht and she was amazing. Every appointment was done on time, informative and clear on what the next steps are. She offered details and support with my every question. Where I wasn’t sure of my German we swapped to English to make sure I understood everything.

The clinic is run in a very efficient way, organized, planned and as a process oriented person I loved it!
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Costs of DNA frag­men­ta­tion tests in Munich

The costs depend on whether the DNA frag­men­ta­tion analy­sis is car­ried out togeth­er with a spermiogram or as a sup­ple­men­tary indi­vid­ual exam­i­na­tion.

To the cost overview
DNA frag­men­ta­tion test incl. spermiogram — approx. €410

The ser­vice includes a com­plete spermiogram as well as the sup­ple­men­tary analy­sis of sperm DNA frag­men­ta­tion, includ­ing med­ical eval­u­a­tion and report­ing.

Make an appoint­ment
DNA frag­men­ta­tion test — approx. €265

If a spermiogram from our fer­til­i­ty cen­ter that is no more than six weeks old is already avail­able, the DNA frag­men­ta­tion can be exam­ined sep­a­rate­ly.

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Notes on Billing

No fixed or flat-rate prices: We bill on the basis of the offi­cial scale of fees for doc­tors (GOÄ). Accord­ing to the GOÄ, we are not allowed to quote fixed or flat-rate prices for med­ical ser­vices. The prices men­tioned are intend­ed to pro­vide ori­en­ta­tion and are typ­i­cal for the treat­ments men­tioned.

Pos­si­ble VAT lia­bil­i­ty: Med­ical ser­vices may be sub­ject to VAT (cur­rent­ly 19%). This applies if, after diag­nos­tics have been car­ried out, no med­ical indi­ca­tion or con­firmed diag­no­sis is present and it is there­fore not a med­ical treat­ment in the strict sense. This can be the case in par­tic­u­lar with social freez­ing treat­ments, but also with the treat­ment of sin­gle moms and same-sex cou­ples.

Note on Cost Cov­er­age

We would be hap­py to pro­vide you with detailed cost infor­ma­tion for the planned treat­ment in advance. This allows you to clar­i­fy cost cov­er­age with your pri­vate health insur­ance (PKV) as best as pos­si­ble before­hand. Statu­to­ry health insur­ance (GKV) does not cov­er costs at our cen­ter.

Fre­quent­ly asked ques­tions about DNA frag­men­ta­tion

What is the dif­fer­ence between a spermiogram and a DNA frag­men­ta­tion test?

The spermiogram pri­mar­i­ly assess­es the num­ber, motil­i­ty, and shape of sperm. Dam­age to the sperm DNA is not vis­i­ble. The DNA frag­men­ta­tion test com­ple­ments the spermiogram and specif­i­cal­ly exam­ines the qual­i­ty of the sper­m’s genet­ic mate­r­i­al.

Can DNA frag­men­ta­tion be increased despite an incon­spic­u­ous spermiogram?

Yes. Sperm can appear incon­spic­u­ous in a clas­sic spermiogram and still have dam­age to their DNA. Stud­ies show that in about 10–15% of men with an unful­filled desire to have chil­dren, increased DNA frag­men­ta­tion can be present despite an incon­spic­u­ous spermiogram. A DNA frag­men­ta­tion analy­sis can there­fore pro­vide impor­tant addi­tion­al infor­ma­tion, espe­cial­ly in cas­es of unex­plained infer­til­i­ty.

Can you get preg­nant despite increased DNA frag­men­ta­tion?

Yes. Increased DNA frag­men­ta­tion does not mean that a nat­ur­al preg­nan­cy is impos­si­ble. How­ev­er, it can be asso­ci­at­ed with low­er chances of preg­nan­cy, impaired embry­on­ic devel­op­ment, and an increased risk of mis­car­riage. How rel­e­vant the find­ing is in an indi­vid­ual case always depends on the over­all fer­til­i­ty sit­u­a­tion.

Can increased DNA frag­men­ta­tion cause mis­car­riages?

Increased DNA frag­men­ta­tion of the sperm is asso­ci­at­ed with an increased risk of mis­car­riages, as pater­nal DNA is impor­tant for ear­ly embry­on­ic devel­op­ment. How­ev­er, it is only one of sev­er­al pos­si­ble fac­tors. The age and egg qual­i­ty of the woman as well as oth­er med­ical caus­es also play a role.

What caus­es can increased DNA frag­men­ta­tion have?

Pos­si­ble caus­es include smok­ing, high alco­hol con­sump­tion, a varic­o­cele, infec­tions or inflam­ma­tion, advanced age, obe­si­ty, and meta­bol­ic dis­eases, as well as cer­tain med­ica­tions or pre­vi­ous chemother­a­py or radi­a­tion ther­a­py. Oxida­tive stress often plays an impor­tant role, and a sin­gle cause can­not always be iden­ti­fied.

Can increased DNA frag­men­ta­tion improve?

Yes, this is pos­si­ble depend­ing on the cause. Treat­able trig­gers such as a varic­o­cele or inflam­ma­tion can be addressed specif­i­cal­ly. Lifestyle changes and, in select­ed cas­es, antiox­i­dant sup­ple­men­ta­tion can also be use­ful. Since the for­ma­tion and mat­u­ra­tion of new sperm takes sev­er­al weeks, we usu­al­ly reassess changes after about three months.

What can be done about increased DNA frag­men­ta­tion?

We first check for pos­si­ble treat­able or influ­ence­able caus­es. Depend­ing on the find­ings, an andro­log­i­cal clar­i­fi­ca­tion, lifestyle changes, tar­get­ed sup­ple­men­ta­tion, or, in the case of fer­til­i­ty treat­ment, spe­cial sperm selec­tion pro­ce­dures such as the ZyMōt® cham­ber may be use­ful. In select­ed cas­es, fur­ther repro­duc­tive med­i­cine mea­sures may also be con­sid­ered.

Which fer­til­i­ty treat­ment is use­ful for increased DNA frag­men­ta­tion?

Increased DNA frag­men­ta­tion does not auto­mat­i­cal­ly mean that ICSI is nec­es­sary. If the oth­er require­ments are favor­able, insem­i­na­tion (IUI) can also be use­ful. In this process, the sperm can be microflu­idi­cal­ly select­ed, for exam­ple using the ZyMōt® cham­ber, in order to obtain a sperm pop­u­la­tion with low­er DNA frag­men­ta­tion.

Whether IUI, IVF, or ICSI is use­ful is decid­ed indi­vid­u­al­ly based on the lev­el of DNA frag­men­ta­tion, the spermiogram, the pre­vi­ous fer­til­i­ty his­to­ry, and the require­ments of both part­ners. Addi­tion­al sperm selec­tion pro­ce­dures can also be used for IVF or ICSI.

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Herzogspitalstraße 5
80331 Munich
Germany

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F: +49 89 123 595 56
hallo@kinderwunschaerztin.de

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