Can Sperm Quality Affect Miscarriage? What the Research Shows

Evidence-based · Written by Dr. Lejla Fazlicic, D.Ac, L.Ac · All key claims cited to peer-reviewed research · Last reviewed October 2026

After a miscarriage, many couples look for a reason. Most of the attention goes to her: her age, her eggs, her body. The male side is often never mentioned, even though half of every embryo's DNA comes from sperm. This article is not about blame. It's about making sure both of you get looked at, so you go into your next cycle with fewer open questions.

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Can sperm quality affect miscarriage?

It can play a part. The standard semen analysis looks at count, movement and shape. It doesn't look at the DNA inside the sperm head. Sperm DNA fragmentation means breaks in that DNA, and it's usually reported as a DFI, or DNA fragmentation index. A sperm with damaged DNA can still look normal and swim well, which is why a normal semen analysis doesn't rule this out. More on that in normal semen analysis but a failed cycle.

The egg can repair some sperm DNA damage after fertilization. How much it can repair varies. That's one reason researchers think high damage may matter more in some couples than in others [4].

What does the research show?

• The large meta-analysis. Robinson and colleagues pooled 16 studies with 2,969 couples. Couples where the male partner had high sperm DNA damage had a miscarriage rate about twice as high as couples with low damage (risk ratio 2.16). The link was strongest when the damage was measured with the TUNEL test [1].
• Recurrent pregnancy loss. A later meta-analysis compared 579 male partners of women with recurrent pregnancy loss with 434 men in control groups. The men in the loss group had higher DFI on average, by about 12 points [2]. The authors noted the studies varied a lot and that there was little data following couples forward in time.

Both are observational. They show a pattern across many couples. They can't tell you what caused a particular loss, and many losses happen when both partners' results are normal.

What the two meta-analyses found

Study	Who was included	What was found
Robinson 2012 [1]	16 studies, 2,969 couples	High vs low sperm DNA damage: about twice the miscarriage rate
McQueen 2019 [2]	579 partners of women with recurrent loss, 434 controls	Higher average DFI in the loss group, about 12 points

Should he have a sperm DNA test after a miscarriage?

The AUA/ASRM guideline on male infertility doesn't recommend a sperm DNA fragmentation test as part of the first, routine workup. It does say that when a couple has had recurrent pregnancy loss, the male partner should be evaluated, including a karyotype and a sperm DNA fragmentation test [3]. That recommendation is graded C, which means the evidence behind it is still limited.

A recent clinical review on how to use sperm DNA testing also lists recurrent pregnancy loss as one of the situations where testing can help a couple and their clinic plan the next step [5].

Whether the test is right for you, and how to read the result, is a conversation for your fertility clinic or a urologist. If you want help with what to ask, see questions to ask before your next IVF cycle and the four sperm DNA test types.

What can he do in the meantime?

Sperm take about 74 days to develop [6]. That gives you a real window before a next cycle. The everyday factors most often linked to sperm DNA damage include smoking, heat, heavy drinking, poor sleep and a diet low in fruit, vegetables and nuts. Our guide to what causes sperm DNA fragmentation goes through each one.

• If he smokes or vapes, this is a good time to stop. See vaping vs smoking before IVF.
• Keep heat away from the testes: no laptop on the lap, fewer hot tubs and saunas. See heat and sperm before IVF.
• Eat more like the Mediterranean pattern: vegetables, fruit, nuts, fish, olive oil. See the male fertility diet.
• Keep alcohol low and protect sleep.

These habits are linked to sperm health in research. They're not a promise about any result, and they're not a treatment for a high DFI. They're the part of the next 74 days he can do himself.

How do you talk about this as a couple?

This topic can feel heavy for him. Some men hear "your sperm may have caused the miscarriage." That isn't what the research says, and it isn't what this article says.

• Frame it as completeness. "I want both of us to be checked, so we're not guessing."
• Do the habits together. Most of what supports sperm health supports her health too.
• Let him take one thing on. Booking his appointment or tracking his 74 days gives him a clear part to play.

More on this in preparing for IVF as a couple.

What the research can't tell you

• What caused a particular miscarriage. The studies show patterns across groups.
• That lowering DFI will prevent a loss. That hasn't been shown in trials.
• That a normal DFI rules everything out. Many factors are involved, on both sides.

What we do with this

1. If you've had more than one loss, ask your clinic or a urologist whether he should be evaluated, including a sperm DNA test.
2. Use the 74 days before the next cycle for the daily habits linked to sperm health.
3. Keep it a shared project, not a search for who's at fault.

In my clinical experience, the habits matter for two reasons. Some couples see changes in their results. Just as often, he says it helps to finally have something to do, after months of feeling like a bystander.

His Pocket Coach turns the 74-day habits into small daily steps, with a food guide and short evening practices, so he isn't working from a list he found online. Try it free for 7 days.

Related reading

• Male factors, embryo quality and implantation
• What is a normal DFI?
• What causes sperm DNA fragmentation?
• Was the failed cycle my fault?

Frequently asked questions

Can sperm quality cause miscarriage?

Research links higher sperm DNA damage with a higher miscarriage rate. A meta-analysis of 16 studies found the rate was about twice as high when damage was high. That's an association across groups. It doesn't show that sperm caused any one loss, and many losses happen with normal results on both sides.

Does a normal semen analysis rule out sperm problems after a miscarriage?

Not completely. A standard semen analysis looks at count, movement and shape, not the DNA inside the sperm. A sperm DNA fragmentation test measures DNA breaks. Ask your clinic or a urologist whether it makes sense for you.

When should a man get a sperm DNA fragmentation test?

The AUA/ASRM guideline doesn't recommend it for every couple's first workup. It does suggest evaluating the male partner, including a sperm DNA fragmentation test, when a couple has had recurrent pregnancy loss. Your clinic or a urologist can tell you whether it fits your situation.

Can he lower his sperm DNA fragmentation before the next cycle?

Sperm take about 74 days to develop, so habits in the months before a cycle can matter. Not smoking, avoiding heat, keeping alcohol low, sleeping well and eating a Mediterranean-style diet are linked to sperm health. They're not a promise about any result, and treatment decisions belong with your clinic.

Is a miscarriage the man's fault if his DFI is high?

No. A high DFI is linked to a higher rate across groups, not a cause in any one couple. A loss is never one person's fault. Checking both partners is about having fewer open questions before your next cycle.

References

1. Robinson L, Gallos ID, Conner SJ, et al. The effect of sperm DNA fragmentation on miscarriage rates: a systematic review and meta-analysis. Human Reproduction. 2012;27(10):2908–2917. https://academic.oup.com/humrep/article/27/10/2908/749072
2. McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertility and Sterility. 2019;112(1):54–60.e3. https://pubmed.ncbi.nlm.nih.gov/31056315/
3. American Urological Association / American Society for Reproductive Medicine. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline (2020; amended 2024). https://www.auanet.org/guidelines-and-quality/guidelines/male-infertility
4. Aitken RJ, De Iuliis GN. On the possible origins of DNA damage in human spermatozoa. Molecular Human Reproduction. 2010;16(1):3–13. https://academic.oup.com/molehr/article/16/1/3/1056419
5. Esteves SC, Humaidan P. Sperm DNA fragmentation: how to test, when to test, and what to do with abnormal results — a pragmatic mini-review for clinical practice. Human Reproduction. 2026;41(7):1024–1039. https://academic.oup.com/humrep/article/41/7/1024/8664338
6. Heller CG, Clermont Y. Spermatogenesis in man: an estimate of its duration. Science. 1963;140(3563):184–186. https://www.science.org/doi/10.1126/science.140.3563.184

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This article is educational and reflects associations reported in the scientific literature. It is not medical advice, not a diagnosis, and not a way to interpret your own results. As a Doctor of Acupuncture I offer lifestyle guidance that works alongside your physician and fertility clinic — I do not diagnose, interpret labs, or prescribe. Your clinic may have its own protocol; follow it and raise any questions with your medical team.