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The SCSA test determines the stability of sperm DNA using the DFI (DNA Fragmentation Index)
In particular, couples who have wanted to have children for a long time and/or couples who have had negative outcomes after several treatment cycles benefit from the test.
It can help to achieve a successful pregnancy as directly as possible.
Below you’ll find answers to the questions we get asked the most
IUI = intrauterine insemination
The IUI is usually the first step in fertility treatment and is aimed at, for example, in couples with unexplained infertility. The ejaculate is processed in the laboratory and placed in the uterus with a catheter. From there, the sperm swim to the fallopian tube to fertilize an egg.
IVF = in vitro fertilization
In IVF, the fertilization of sperm and egg takes place outside the body. For fertilization, egg cells and prepared sperm are put together in a Petri dish. After successful fertilization, the embryo(s) are transferred to the uterus to implant.
IVF is used, for example, in the case of blocked fallopian tubes or in the absence of a pregnancy after previous IUI treatments.
ICSI = intracytoplasmic sperm injection
In ICSI, the fertilization of the sperm and egg takes place outside the body. The main difference from IVF is that the fertilization of the oocytes is carried out under the microscope by selecting sperm and injecting them directly into the oocytes. After successful fertilization, the embryo(s) are transferred to the uterus. Indications for ICSI are, for example, limited semen parameters and absent pregnancies after previous IVF treatments.
Depending on the stability of the DNA , different stress factors (see Causes) can cause damage to the sperm DNA , which is referred to as “sperm DNA fragmentation”.
The SCSA test is used to assess the quality of the sperm, which is of great importance for normal fertilization of the egg cell, undisturbed embryo development and a successful pregnancy.
DFI (DNA Fragmentation Index) :
The DNA Fragmentation Index (DFI) is the measure of sperm DNA fragmentation and an indicator of sperm quality.
A low DFI (<15%) indicates stable sperm DNA .
A high DFI (>25%) indicates unstable/brittle sperm DNA that is sensitive to stimuli and consequently easily damaged. The damage in sperm can lead to impaired embryo development or repeated miscarriages after fertilization of the egg.
HDS (High DNA Stainability Cells): Percentage of immature sperm
Mature sperm play a major role in the fertilization of the egg cell, among other things.
The SCSA® test is performed using a laser-based device called a flow-cytometer which measures 250 sperm/second. The test result is based on the measurment of around 10,000 sperm.
The quality of the sperm is evaluated with the parameters mentioned (DFI and HDS) and can influence the further course of your fertility treatment. Depending on the outcome of the test, special treatment options can be sought to get one step closer to a successful pregnancy.
SCREENING TEST : Particularly suitable for couples with a long-awaited desire to have children
UNSUCCESSFUL IUI/IVF/ICSI ATTEMPTS
REPEATED MISSORS
POOR EMBRYO DEVELOPMENT AND QUALITY
UNEXPLAINED BARRENESS: Couples who want to have children and have unremarkable diagnostic tests
MEN PRONE TO HIGH OXIDATIVE STRESS:
LIFESTYLE: smoking, drug use, increased alcohol consumption, obesity, stress
NUTRITION: Although commonly overlooked, we have often seen drastic improvement in sperm DNA fragmentation after a detailed analysis and correction of daily nutrition.
HEAT EXPOSURE: e.g. from whirlpool baths, working with a laptop on the lap, fever, etc.
OCCUPATIONAL EXPOSURES: chemicals, pesticides, fertilizers, dyes, etc.
DIABETES: An independent risk factor for increased sperm DNA fragmentation
MEDICATION: Even the most unassuming medications have sometimes seen to cause sperm DNA fragmentation
ENVIRONMENTAL TOXINS /air pollution: Although it may appear general, a keen look into exposure should be ruled out.
VARICOCELE: Once diagnosed either by examination or ultrasound, SCSA test can help in the decision if surgery will help.
CANCER AND CANCER TREATMENTS (chemotherapy and radiotherapy) : causes direct damage to the DNA of cells.
CHRONIC DISEASES: often cause increased oxidative stress leading to increased DNA damage
ANDROLOGICAL DISEASES / Infections of the urogenital tract and leukocytospermia: Local infection / inflammation causes direct damage to the DNA in sperm through release of ROS (Reactive Oxygen Species).
AGE >40 YEARS: It has been extensively studied that the older the man, the higher the DNA fragmentation
LUBRICANTS: cause direct damage to the sperm DNA
A classic spermiogram is the basis for male fertility diagnostics.
Checked:
sperm count
sperm motility
Sperm morphology
BUT: No measurement of sperm quality (degree of DNA fragmentation)
After all, it is the sperm DNA that influences the development of the embryo and the outcome of the pregnancy
Assessing sperm DNA quality
Since DFI and HDS are within the normal range, pregnancy is possible naturally or by insemination (ignoring partner factors affecting fertility)
That means the DNA of the sperm shows a high stability 
The DFI is greatly increased. This means that the sperm DNA is very fragile and tends towards DNA fragmentation
Stabilization of DNA can be achieved by:
It may be necessary to switch from IUI to IVF/ICSI to increase the chances of a positive pregnancy outcome
Please speak with your treating physician regarding the cost of the test. It is currently not covered by insurance.
The transport of your sample to our laboratory is free of charge.
For DFI values >30%, we offer you a second free control test, which should normally take place 3 months after the first test.
Please contact us for the cost of the test. It is currently not covered by insurance.
Sending the samples to our laboratory is free of charge.
For DFI values >30%, we offer a second free control test, which should normally take place 3 months after the first test.
The SCSA test measures the DNA Fragmentation Index (DFI) of your sperm.
This helps identify and correctly treat a couple for quicker and successful pregnancy especially in patients who have been attempting pregnancy for a long time or have multiple failed treatment cycles.
Below you’ll find answers to the questions we get asked the most
External and internal factors can cause abnormally increased damage to the DNA in the sperm called “Sperm DNA fragmentation” which leads to poor embryo development or reccuring miscarriages.
DFI (DNA Fragmentation Index) :
Percentage of sperm with DNA fragmentation
HDS (High DNA Stainability Cells): Percentage of sperm with abnormal core proteins and chromatin structures (immature sperm)
The SCSA® test is performed using a laser-based device called a flow-cytometer which measures 250 sperm/second. The test result is based on the measurment of around 10,000 sperm.
A semen analysis checks:
-Sperm concentration
-Sperm motility
-Sperm morphology
However, the level of DNA fragmentation in the sperm head is not measured.
It is finally the sperm DNA that influences the embryo development and pregnancy outcome
Above is the histogram of the DFI measured in a sperm sample
The SCSA clinical report lists four statistical categories of fertility potential (without female infertility factors):
< 15% DFI = Excellent to good pregnancy outcomes
> 15% to < 25% DFI = good to fair pregnancy outcomes
> 25% to < 40% DFI = fair to poor pregnancy outcomes
> 40% DFI = Very poor pregnancy outcomes
When %DFI is above 25%, current literature suggests that the patient can:
REPEATED IUI / IVF / ICSI FAILURE : The reason behind the unsuccessful attempts at IUI/IVF/ICSI can be identified and managed
REPEATED MISCARRAGE : An explanation for repeated spontaneous abortions (RPL, repeated miscarriage) could be found and guided
POOR EMBRYO DEVELOPMENT AND QUALITY : The reason behind poor embryo quality could be the fragmented sperm DNA which could be corrected before the next treatment
MEN AT RISK FOR HIGHER OXIDATIVE STRESS:INITIAL SCREENING TEST : Especially for couples who have been attempting pregnancy for a long time to identify the best management strategy
UNEXPLAINED INFERTILITY : Couples desiring children with all normal diagnostic tests
LIFESTYLE: smoking, drug use, increased alcohol consumption, obesity, stress
NUTRITION: Although commonly overlooked, we have often seen drastic improvement in sperm DNA fragmentation after a detailed analysis and correction of daily nutrition.
HEAT EXPOSURE: e.g. from whirlpool baths, working with a laptop on the lap, fever, etc.
OCCUPATIONAL EXPOSURES: chemicals, pesticides, fertilizers, dyes, etc.
DIABETES: An independent risk factor for increased sperm DNA fragmentation
MEDICATION: Even the most unassuming medications have sometimes seen to cause sperm DNA fragmentation
ENVIRONMENTAL TOXINS /air pollution: Although it may appear general, a keen look into exposure should be ruled out.
VARICOCELE: Once diagnosed either by examination or ultrasound, SCSA test can help in the decision if surgery will help.
CANCER AND CANCER TREATMENTS (chemotherapy and radiotherapy) : causes direct damage to the DNA of cells.
CHRONIC DISEASES: often cause increased oxidative stress leading to increased DNA damage
ANDROLOGICAL DISEASES / Infections of the urogenital tract and leukocytospermia: Local infection / inflammation causes direct damage to the DNA in sperm through release of ROS (Reactive Oxygen Species).
AGE >40 YEARS: It has been extensively studied that the older the man, the higher the DNA fragmentation
LUBRICANTS: cause direct damage to the sperm DNA
This is usually a question after receiving an indererminate semen analysis report or after failing an IUI treatment.
An SCSA test can give a clear and direct answer.
When 27-30% sperm DNA was fragmented (%DFI) these couples were 7-10 times less likely to concieve with intercourse or IUI and more likely to become pregnant through IVF/ICSI.
After 24-48 hours of abstinence, the samples should be taken by masturbation into sterile plastic sample containers. After liquefaction of the sample, the sperm concentration, motility and morphology are determined.
Cryopreservation should take place no more than 1 hour after delivery, since the DFI can be falsely raised after a longer waiting period.
Flash-freezing: Freeze 0.25mL or more of liquefied native ejaculate in 1-2mL cryovials. Cryoprotectants is not required! (Please freeze 2 cryovials per patient)
Samples should be frozen as soon as possible after liquefaction to minimize exposure to air, which can cause damage caused by reactive oxygen species.Cryovials should be tightly capped, labeled with two identifiers (e.g. name and date of birth) and placed in an upright position directly into the pre-chilled cryo-container. The container must be closed quickly.
Note: Cryoprotectants are not needed since quick-frozen sperm give the clearest SCSA® data. This feature is unique to mammalian sperm cells due to the highly condensed, crystalline nature of the nuclei.
Note: If the sperm concentration is adequate, less than 0.5 mL (two 0.25 mL aliquots) of semen may be sufficient for the SCSA® test. To perform the test, we require two 0.20 mL aliquots with a concentration of >0.5 million/ml. Please contact our laboratory if you have questions pertaining to the volume necessary for a sample of a certain concentration.
We ship a pre-chilled dry shipper. Dry shippers store the liquid nitrogen in porous material and thus ensure the safe transport of your cryopreserved samples in the nitrogen gas phase.
The low temperature in the container can be maintained for 7 days. It is therefore important to send it back as soon as possible using the mailed/supplied shipping label.
Note: liquid nitrogen is adsorbed by special materials inside the shipping container. Even if they are turned upside down during transport, no liquid nitrogen will leak out. Dry shippers are not considered dangerous.
The cost of the test is 295 Euro.
* Samples are shipped in a pre-cooled shipper that we can provide either at ambient or pre-chilled temperatures. The pre-cooled shipper will be sent to the centre where you have provided your sample for the centre to ship it to us.
The test at present is not covered by the insurance.
Please write us an email to contact@scsalab.com and we will let you know the centers near you where you could get the test done at your convenience.
After receiving the sample(s) in our laboratory, we need 4 working days to create a report, which we will send to you.
The cost of the test is 295 Euro.
* Samples are shipped in a pre-cooled shipper that we can provide either at ambient or pre-chilled temperatures. The pre-cooled shipper will be sent to the centre where you have provided your sample for the centre to ship it to us.
The test at present is not covered by the insurance.
Please write us an email to contact@scsalab.com and after contacting you, we will send toy a dry shipper for the patient sample to be sent to us.
– Cheryl T – Boston
Thank you for your help in solving our problem. Ever since we got married a little over a year ago, we’ve been trying to conceive.
It was only after the test showed a DFI of 40% that we realized that the possible cause of the high DFI was the medication my husband was taking for stress at work .
We had another test two months later to stop taking the medication on medical advice. We were happy and surprised that the DFI had dropped to 12%. And now we are pregnant!!! Many Thanks
I have had five miscarriages after previous ICSI treatments. As I sat in the waiting room at my clinic, I read an article in Fertility Today that you wrote about recurrent miscarriages. My husband’s SCSA test showed a DFI of 75% . My doctor was convinced that the high DFI was probably the cause of the miscarriages .
– Susan J – Houston, TX
– Kelly N. – New York City