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Damage to sperm DNA provides powerful insights to male fertility

Guest blog from Prof. Sheena Lewis from

You may be surprised – or possibly reassured – to learn that more than a quarter of couples having fertility investigations are told that neither of them has any detectable problems (1). This is frustrating for both the fertility expert and the couples trying desperately to have a baby. Which pathway will take them a step in the right direction? How do they know where to start? Tackling infertility effectively can only really begin if we understand the main causes.  

Sperm quality over quantity 

In 2018, the UK Human Fertilization and Embryology Authority reported that male problems were the most common reason for having fertility treatment (2) so men should be checked out very carefully. What’s astounding is that when male fertility is finally looked at, (this is always secondary to female investigations) the focus is on semen analysis, and sperm quantity over quality! And when men have a normal semen analysis, they are highly unlikely to be investigated any further. With seemingly no obvious cause for their fertility problems, the male fertility investigation stops right there, and attention is directed back to the woman. 

A vital yet missing component of the standard fertility investigational process in couples is sperm health. Research has shown that 20-40 % of men with ‘unexplained’ infertility have high DNA damage (or fragmentation) in their sperm (3) (4) and this has been shown to have strong links with miscarriage as well as the likelihood of Assisted Reproductive Treatment (ART) success (5). 

The quality of sperm DNA is vital as it carries a copy of the genes that a man passes on to their baby. Not only do these genes pass on characteristics like eye color or height, but they build our brains and determine our behaviour and future health. 

Here are answers to a few questions we are frequently asked, to help all men and their partners reading our post: 

Why test sperm DNA? 

While sperm DNA damage is a leading cause of male infertility, it is not tested routinely in most clinics. Even though you can have a normal semen analysis, your sperm DNA damage could be high. That makes it less likely that you would get your partner pregnant naturally, or even with treatment (6). Men with high levels of damaged sperm DNA also have double the risk of miscarriage. 

Not only is sperm DNA part of your baby’s blueprint, but the quality of your sperm DNA will help fertility experts predict the fertility treatment with the highest likelihood of success for you. This means that you could potentially improve your chances of getting pregnant with fewer treatment cycles. 

Lifestyle changes and clinical interventions can improve sperm DNA damage.  Measuring and understanding levels of sperm DNA fragmentation is so important to help more men become dads.  Some sperm DNA damage happens when sperm are being made; by snapping some of the DNA strands. This can’t be prevented, but men do have the power to reduce the DNA damage caused by lifestyle hazards like smoking or being overweight. With the right understanding and advice, men can protect and improve their sperm health.  

Where can you get tested? 

Examen’s Exact sperm DNA tests, based on over 25 years of fertility research, measure the level of DNA damage in sperm (test results within just 10 days). A test will give you and your fertility expert a better understanding of your sperm quality and the best course of treatment for you.

Exact tests are available in most fertility clinics in the UK, and we are pleased to be expanding access in Europe. ExSeed Health, Examen and Skive fertility clinic in Denmark are in collaboration in a research project to measure improvements in poor sperm quality with life-style interventions.  


Evaluation of the Effect of a Multimodal Lifestyle Program on Semen Quality and DNA Fragmentation in Male Patients Attending Fertility Treatment. 

Reduced sperm quality and damage to DNA in sperm cells are believed to cause reduced fertility in approximately 40% of infertile couples. In addition to decreased fertility, damage to sperm DNA often contributes to an increased number of point mutations in the foetus and baby. This can result in spontaneous abortions, congenital malformations or illnesses in children and adolescents such as autism and schizophrenia. With this project, poor sperm quality is attempted to be improved with the help of ExSeed’s personalized lifestyle guidance. The project is expected to be finalized in Q4 2021. 

Get your sperm in the best possible shape 

Once you get a diagnosis (analysis of sperm parameters and DNA) you can take back control. Even if you do have high levels of sperm DNA fragmentation, it is possible to reduce sperm DNA damage with lifestyle changes, and increase the likelihood of getting pregnant both naturally or with fertility treatment such as IVF or ICSI. For easy ways to improve sperm health, have a look at our lifestyle blog article.  

Don’t delay analysing levels of sperm DNA damage  

Powered by Examen’s proprietary SpermComet® technology, the Exact® range of sperm DNA diagnostic tests provide essential information for fertility specialists to help them diagnose male infertility and make the best treatment decisions for their patients. 

Speak to Examen’s fertility expert about Exact Sperm DNA Tests and map out the pathway which is most appropriate for your individual circumstance.  

Examen’s team in the UK is delighted to bring Exact tests to Denmark, thanks to Professor Peter Humaidan. 

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Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.


Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.


Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.


Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.


There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  


A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.


Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.