Sperm Damage

New evidence suggests that oxidative stress and DNA damage in sperm may contribute to repeated; miscarriages in female partners; according to a small study presented here at ENDO 2019; The Endocrine Society Annual Meeting. A strong understanding of female factors that can contribute to recurrent pregnancy loss exists, but researchers know far less about malefactors that may play a role.

Three consecutive miscarriages

Recurrent pregnancy loss at least three consecutive miscarriages (before 20 weeks’ gestation); occurs in 1-2% of couples, and about half of cases are unexplained. “Affected women undergo many tests to determine the cause, but many cases have no identified cause. It’s important to know that both males and females need to screen for conditions; that can acknowledge and investigate when they attend miscarriage clinics.
And it’s key “for clinicians to ask male partners what their medical history is, examine them; may offer a further investigation so that we can establish where the problem is,” and perhaps offer the couple better treatment, she added. These preliminary findings make you aware of the fact that; when a woman has a recurrent pregnancy loss; that does not happen in isolation.” That really reverses the way clinicians often think about this.
“They are focused on the patient having a recurrent pregnancy loss, but there is a partner involved, so the real message is that there may two components contributing.” Known risk factors for male infertility include genitourinary infection, varicocele, scrotal heat, and obesity. Dimakopoulou and colleagues hypothesized some of these conditions might contribute to reactive oxygen species in semen; which could then cause sperm DNA fragmentation and subsequent pregnancy loss.

Implications for the management

Our data have important implications for the management of couples with RPL as male partners of [such] women may benefit from routine assessment of reproductive endocrine and sperm function,” note Dimakopoulou and colleagues. Indeed, it may one day “possible to design future drugs to stop sperm DNA damage to treat couples with recurrent pregnancy loss and reduce the risk of miscarriage.

Researchers also acknowledge there were study limitations; including that the control males had not confirmed as proven fathers and no experimental model currently exists to explain; how sperm DNA damage could cause recurrent pregnancy loss, Dimakopoulou said. Another notable limitation was the lack of replicability, or multiple semen samples, noted Page.

Parameters in semen analysis can change a lot from one collection to another even in completely normal, healthy men. So when you see data from just one sample; it’s hard to make any firm conclusions.” But she agreed with the researchers and other commentators on the key take-home message; Do not neglect the male. Sometimes they will screen both potential parents for balanced translocations in the chromosomes, but most of the focus is typically on the woman.”