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Using fecal microbiota transplantation (FMT), Liu et al (93) demonstrated that transferring fecal microbiota from patients with mCRPC into mice led to an increased abundance of intestinal Ruminococcus, marked upregulation of LPCAT1 expression in prostate tissues, and elevated levels of the DNA repair proteins (DNA repair protein RAD51 homolog 1 and DNA-dependent protein kinase catalytic subunit)

If this happens, simply lowering your dose usually solves the problem

Still, ICSI achieves fertilization rates of 60-80%, close to the 70-90% seen with normal sperm