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Updated guidelines incorporate sperm DNA testing for unexplained recurrent miscarriages

The American Society for Reproductive Medicine has added sperm DNA fragmentation testing to its recommended evaluations when other causes are ruled out.

Updated Aug 26, 2026 · 11:21 UTC1 reports

The short version

  • The American Society for Reproductive Medicine updated its guidelines to recommend sperm DNA fragmentation testing for patients with recurrent pregnancy loss when uterine and genetic evaluations do not reveal a cause.
  • Men contribute to roughly 50 percent of infertility cases, but standard semen tests only evaluate sperm count, motility, and structure rather than genetic integrity.
  • DNA fragmentation testing typically costs between $300 and $500, and damaged sperm can sometimes be improved through lifestyle modifications such as diet, exercise, reduced alcohol use, and supplements.

Key facts

  • The American Society for Reproductive Medicine revised its recommendations for evaluating recurrent pregnancy loss, adding sperm DNA fragmentation testing for cases where genetic analysis of miscarriage tissue and uterine evaluations yield no explanation.[Scientific American]
  • Sperm DNA fragmentation involves breaks or damage in the genetic material within sperm, which is linked to miscarriages and lower in vitro fertilization (IVF) live birth rates.[Scientific American]
  • Male factors contribute to approximately 50 percent of infertility cases, with around 20 percent originating from sperm alone and 30 to 40 percent involving sperm alongside other factors.[Scientific American]
  • Sperm DNA fragmentation tests generally cost between $300 and $500.[Scientific American]
  • Lifestyle changes, including improving diet and exercise, eliminating alcohol, and taking vitamin supplements, can in some cases help remediate sperm DNA damage.[Scientific American]

What remains uncertain

  • The extent to which lifestyle interventions can successfully remediate severe cases of sperm DNA fragmentation remains uncertain across all patients.[Scientific American]

Sources