Iron is essential, but too much iron becomes pro-oxidative.

Excess iron can:

• Increase oxidative stress in the testes
• Damage sperm cell membranes
• Disrupt mitochondrial function (energy production for sperm)
• Fragment sperm DNA

And here’s the part that’s often missed: DNA fragmentation does not always show up on a standard semen analysis. In fact, you need to request that your doctor test this and most of our clients have had to really fight to get this done.

So couples are told:

“Everything looks good, just keep trying.”

Meanwhile, early losses or implantation failures keep happening.

Lab Patterns That Often Make Us Look Deeper At Iron

High iron rarely exists in isolation.

Some of the most common lab patterns we see alongside high iron in men include:

• Elevated hemoglobin or hematocrit
• Higher hemoglobin A1c, even without a diabetes diagnosis
• Elevated total cholesterol or LDL

These markers don’t automatically mean iron is the issue, but when we see them together, especially in the context of fertility challenges, it often points to oxidative stress and impaired iron handling. It definitely makes us want to rule out that iron is an issue. We have all of our partners complete a hair tissue mineral analysis as well, which will give more insight into the iron recycling system and if other minerals are impacting iron.

The Miscarriage Connection

High sperm DNA fragmentation has been associated with:

• Early pregnancy loss
• Failed implantation
• Poor embryo development

Even when fertilization occurs, damaged DNA can affect early cell division and embryo signaling, increasing the risk of miscarriage, particularly early losses. Whenever we see recurrent pregnancy loss, especially early on, we recommend the partner get DNA fragmentation tested. It’s not cheap but it’s important to know since identifying this can be the difference between another loss and a healthy pregnancy.

Things We Consider When Iron Is High

This part is highly individualized. Everyone is in a different place with their health and resilience, but here’s what we often consider in practice.

When iron is elevated in our male clients:

• We prioritize mineral support first to ensure the body is equipped to handle changes safely
• If and when someone is ready, we will often recommend a blood donation as a way to reduce iron load
• We then retest labs about 8 weeks later to see how levels have shifted and reassess next steps

Blood donation can be incredibly effective for some men, but timing and readiness matter, which is why we don’t treat this as a blanket recommendation.

The Takeaway

If you’ve been told:

“His labs look fine.”

But you’re still dealing with early miscarriage or unexplained fertility struggles, this is a layer worth exploring.

Male fertility is about more than count and motility.

Sperm DNA integrity matters.

And when we address the underlying stressors, including iron, outcomes can change.

Here are some other great resources around sperm that you may find helpful:

• Why Sperm Health Deserves More Than Just Attention
• The Mineral Connection to Sperm DNA Health
• The Hidden Factor in Sperm Health
• Sperm Quality

​reminder: i’m currently accepting people into my Nurture Your Fertility program. you can learn more here about the program and fill out an application!