Question: Hello Doctor,
I am 33yrs old weighing 91kgs and planning for an IUI. I got my SA & DFI report with following details (result based on first sample):
DNA Fragmentation Index (DFI) : 58%
- Sperm Conc: 13mill/ml
- Sperm Motility : 16% (Slow progressive 14% & non progressive 2%)
- Morphology : Normal forms 2%
- Ultrasonography of scrotum suggests 'Bilateral Vericocele'. Dilated veins measuring upto 2.4mm on right side & 2.6mm on left side and show reflux on valsalva.

Q1: What is the grade & how severe is the Vericocele? Would a corrective surgery improve the SA & DFI parameters?

I am under medication (Cerenos & Paternia) to improve above parameters.

Q2: Can we go for an IUI this cycle? Is there possibility of undesirable results like early miscarriage or abnormality if IUI leads to pregnancy? The chances are very low for success as I understand but my Doc is optimistic to give it a try. My wife is under Clomid this cycle (administered for follicular study) and has 1 mature follicle.

Please advice what should be our next steps, can DNA fragmentation & Sperm paraleters be corrected with any medication/surgery for Vericocele correction?

Thanks Doctor for answering our queries, I am clear on not going for IUI.

- Another thing I missed to include was at the time of SA I did blood test for few parameters:


- FSH               : 5.2 mIU/ml
- LH               : 5.6 mIU/ml
- Serum Prolactin      : 9.8 ng/mL
- E2               : 23pg/mL
- Serum Testesterone     : 2.410 ng/ml
- Serum FREE Testesterone : 53.1 pg/ml

Serum Testesterone levels were below the prescribed range of [2.8 - 11.0]

- Can you suggest 2 or 3 trusted places where I can get SA + DFI test done in XXXXXXX This is to eliminate any aberration in results.

- Is there no remote chance of SA/DFI improvement by Vericocele correction or Testesterone level improvement?

- Is it possible to improve the DFI index by supplements or targeted diet (with required nutrients like zinc etc..)

- I am asking this because even for ICSI the selected Sperm may be motile & morphologicaly good but the DNA characteristics may not be checked.

- If a Sperm with poor DNA is picked for ICSI are there chances of unsuccessful or unhealthy child birth.
- Is there a relation of healthy sperm (motile & good morphology) with DNA i.e., will DNA be intact in a healthy sperm?

Thanks in advance.

Hello Dr. XXXXXXX

Thanks for your response.

After 3 weeks of being on medication (Cernos & Paternia) I repeated the Testosterone & Semen analysis yesterday. To my XXXXXXX the results were worse compared to 3 weeks earlier report which was without any medication.

- Testosterone :~1.4 ng/ml (3 weeks earlier it was 2.410 ng/ml)
- DFI : 55% (3 weeks earlier was 58% - Improved)
- Sperm Conc : 5mil/ml (3 weeks earlier 13mill/ml)
- Sperm Motility : 10% (3 weeks earlier 16%)
- Morphology : 2% Normal forms (Same)

Can you help me understand why this drop in parameters even after medication.
I had also taken 2 injections shots as well (1 HCG & another also for Testosterone). Seems like lower testosterone levels correlate with lower SA parameters.