When a couple experiences miscarriage, the focus of investigation has traditionally fallen on the woman. Hormonal imbalances, immune factors, uterine abnormalities — these are well-recognised causes, and rightly investigated. But for too long, the male contribution to pregnancy loss has been overlooked.
The science is now clear: male fertility can play a significant role in miscarriage. And at the CRP Clinic in Epsom, this is something we take seriously.
The Missing Piece: Sperm DNA Fragmentation
Sperm carry half of the genetic material needed to create a healthy embryo. If that genetic material is damaged, it can compromise the developing pregnancy, even when fertilisation has occurred successfully.
This damage is known as sperm DNA fragmentation (SDF): breaks or lesions within the DNA strand of individual sperm cells. While a standard semen analysis can assess sperm count, movement, and shape, it tells us nothing about the integrity of the DNA inside those sperm.
A man may have a perfectly normal semen analysis and still have high levels of DNA fragmentation.
What Does the Research Tell Us?
Professor Shehata and colleagues at CRP Clinic contributed directly to answering this question. A peer-reviewed study published in ‘Reproductive BioMedicine Online’ (2021) examined sperm DNA fragmentation (measured using the alkaline Comet assay) in 217 men whose partners had experienced miscarriage, compared to 76 fertile donors.
The study found that sperm DNA fragmentation measures were robust biomarkers for both sporadic and recurrent miscarriage, whether conception occurred naturally, or through assisted reproductive techniques such as IVF or IUI. The findings suggest that sperm DNA testing could provide pioneering diagnosis and guide future fertility pathways for couples experiencing pregnancy loss.
(Haddock L, Gordon S, Lewis SEM, Larsen P, Shehata A, Shehata H. Sperm DNA fragmentation is a novel biomarker for early pregnancy loss. Reprod Biomed Online. 2021 Jan;42(1):175–184. doi: 10.1016/j.rbmo.2020.09.016)
This research matters because it places sperm DNA fragmentation not as a peripheral concern, but as a clinically meaningful factor in pregnancy loss, one that deserves to be tested alongside the many investigations women already undergo.
What Causes High Sperm DNA Fragmentation?
A number of lifestyle and medical factors can increase the level of DNA damage within sperm:
- Excess weight or obesity
- Smoking
- Infections (including sexually transmitted infections)
- Elevated scrotal temperature (e.g. from hot baths, laptops, or tight clothing)
- Varicocele (enlarged veins in the scrotum)
- Exposure to heavy metals or environmental toxins
- Chemotherapy or radiotherapy
- Certain medications
Many of these factors are modifiable. Identifying them early means there is often something that can be done.

Testing at CRP Clinic
At CRP Clinic, we offer specialist sperm DNA integrity testing as part of our comprehensive couple assessment.
The process is straightforward. Men are advised to ejaculate two to three times in the week before the test, then abstain for 48 hours prior to providing the sample. The sample is sent to a laboratory in Copenhagen, preserved in liquid nitrogen, for detailed analysis.
If results show elevated DNA fragmentation, we arrange a consultation with our specialist urologist, Mr Stephen Gordon, for further evaluation and to explore treatment options.
Following any recommended treatment, a complimentary repeat test is offered after three to six months to assess the impact on sperm health.
What Happens If Fragmentation Is High?
Where high sperm DNA fragmentation is identified and couples are proceeding with IUI, we offer an advanced sperm selection technique called Zymot microfluidic separation. This device selects sperm with the least amount of DNA damage, which may improve the chances of a successful pregnancy in eligible couples.
For couples undergoing IVF, identifying high fragmentation can also inform decisions about fertilisation technique and embryo selection.
A Shared Journey
Miscarriage is never the fault of either partner. But understanding all the contributing factors, including male factors, gives couples the best possible chance of finding answers and moving forward with a targeted, evidence-based treatment plan.
At CRP Clinic, we investigate both partners thoroughly. Over 80% of our patients go on to have successful pregnancies following our tailored treatment programs. That outcome is possible because we look at the full picture.
Take the Next Step
If you have experienced recurrent pregnancy loss or unexplained miscarriage, we encourage you to reach out. Our team, led by Professor Hassan Shehata, will listen carefully, investigate thoroughly, and walk with you every step of the way.
