Sperm DNA damage emerges as key factor in recurrent pregnancy loss
New clinical guidance highlights that sperm DNA fragmentation can contribute to recurrent miscarriage, even when standard sperm counts and motility appear normal. The condition is also associated with lower success rates in IVF, as damaged genetic material in sperm may impair embryo development after fertilization. Updated recommendations now suggest testing for sperm DNA fragmentation when other causes of repeated pregnancy loss have been ruled out.
Sperm DNA fragmentation testing has been available for decades, yet it has remained underutilized in standard fertility workups. The American Society for Reproductive Medicine's 2026 guidance update—its first since 2012—now endorses the test, but only after uterine structure exams and genetic analysis of miscarriage tissue have ruled out other causes. This conditional recommendation reflects a cautious shift in clinical practice.
The broader picture is striking: male factors contribute to roughly half of all infertility cases, with sperm alone responsible for about 20 percent. The remaining 30 to 40 percent involve combined male and female factors. Because damaged sperm DNA can impair embryo development even after fertilization occurs, the condition may silently undermine both natural conception and assisted reproduction.
This guidance could reshape how fertility clinics evaluate couples experiencing recurrent pregnancy loss, potentially shifting blame and burden away from women, who have historically borne the brunt of fertility testing and treatment. Affected couples may gain new diagnostic avenues and lifestyle-based interventions, such as reducing alcohol intake or improving diet, before pursuing more invasive procedures. However, broader adoption of testing may depend on insurance coverage and clinician awareness, meaning access could vary significantly across regions and socioeconomic groups.