Sperm DNA integrity and IVF outcomes: more to consider

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Male fertility is a complex issue, especially when coupled with IVF procedures. Beyond standard sperm analysis (count, shape and motility), analyzing the integrity of the DNA insider the sperm cells – using the DNA Fragmentation Index, or DFI, is a topic that I’m seeing more and more in research and practice, including in these past posts about recurrent pregnancy loss and IUI outcomes.

A new 2024 study from China’s Shangqiu Hospital has looked specifically at DFI in IVF cases where intracytoplasmic sperm injection (ICSI) is used to manually insert a sperm into a follicle, when shape/morphology and motility are poor. ICSI is often thought to be a go-around for poor sperm parameters.

For reference, a DFI <15% is considered normal, while 15-30% is considered average, and DFI >30% is considered poor integrity.

The researchers looked at whether DFI plays a role in the long-term outcomes of over 6000 IVF/ICSI procedures – and found that, while fertilization rates were unaffected by poor DFI (with ICSI, egg and sperm are able to meet and fertilize), there was a significantly higher miscarriage rate when DFI was poor and average (15-30%), compared to normal (<15%). Secondly, they found that infant birth weights were significantly lower for cases where DFI was poor and average (>15%), compared to DFI normal (DFI <15%). 

In short, the study concluded that sperm DFI had an impact on both miscarriage rates and birth weights in IVF/ICSI pregnancies.  

Moreover, the research demonstrates that “average” DFI (15-30%) still merits evaluation and treatment focus, which would include removing oxidative stressors that damage sperm DNA, as well as providing anti-oxidative support – both of which I discuss in my fertility course.

I hope you have found this helpful, and do let me know if you have any questions!

If you are hungry for more evidence-based information for your fertility or pregnancy journey, visit for free webinars and complete programs.

And if you are a care-provider looking for evidence-based resources for your fertility or pregnancy patients, please get in touch with us at, or visit

In health,

Dr Jocelyn Land-Murphy, ND

Terra Life

Disclaimer: The information and content provided is for general educational and informational purposes only and is not professional medical advice, nor is it intended to be a substitute therefore. Please consult the Disclaimer and Terms of Use for full details.


Li, F. et al. (2024).Sperm DNA fragmentation index affect pregnancy outcomes and offspring safety in assisted reproductive technology. Scientific Reports, 356 (2024).

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8 Proven Shortcuts To A Healthy Pregnancy

it's free!
Protecting your personal information is of utmost importance to me