Comparison of the Efficiency of Magnetic-Activated Cell Sorting (MACS) and Physiological Intracytoplasmic Sperm Injection (PICSI) for Sperm Selection in Cases with Unexplained Infertility

Abstract

Background: The cases with unexplained infertility may have an abnormality in their sperm chromatin structure. Sperm selection methods can be used to separate sperm with low DNA fragmentation. The purpose of this study was to compare the efficacy of physiological intracytoplasmic sperm injection (PICSI) with magnetic-activated cell sorting (MACS) in assisted reproductive techniques in cases with unexplained infertility.
 Methods: The semen samples were collected from couples with unexplained infertility. After semen analysis and sperm DNA fragmentation (SDF) evaluations, samples were prepared with swim-up method. The rates of SDF in different fractions including raw semen (n=20), swim-up (n=20), only motile sperm after swim-up (swim-up selection) (n=20), MACS sperm selection (n=20), only motile sperm after MACS (MACS selection) (n=20), and PICSI sperm selection (n=16) were evaluated. Also, the main sperm characteristics and fine morphology of sperm suspension after MACS were assessed. Statistical analysis was performed using GraphPad Prism. The p<0.05 was considered statistically significant.
 Results: DNA fragmentation index (DFI) values in PICSI and MACS groups were significantly reduced as compared to the swim-up group. The rate of this reduction was more pronounced in MACS (58.20±13.02) than PICSI (36.57±15.52) group. Also, our results showed that MACS resulted in decreased sperm motility, with no alteration in their fine morphology.
 Conclusion: MACS was found to be more efficient in reduction of SDF rates than PICSI. However, none of the sperm selection techniques can not totally eliminated the spermatozoa with DNA fragmentation in the final sperm sample.

Sperm DNA fragmentation: association with infertility and methods of correction

“…Целая серия исследований посвящена оценке эффективности описанных выше методов как способа отбора сперматозоидов без повреждённой ДНК. Так, в ряде исследований продемонстрировано улучше- Обзор ние клинических результатов у пациентов с высоким уровнем фрагментации ДНК при применении современных методов PICSI и MACS по сравнению со стандартными процедурами центрифугирования в градиенте плотности и техникой всплывания спермы [33][34][35]. Стандартные методы показывают значимую эффективность в качестве техники отбора сперматозоида лишь при отсутствии повреждений генетического материала.…”

Application of Physiological Sperm Selection in Assisted Reproductive Technology (ART) for Patients With Diabetes Mellitus: A Case Report

“…In situations of abnormal sperm DNA fragmentation (SDF), physiological intracytoplasmic sperm injection (PICSI) and magnetic-activated cell sorting (MACS) are beneficial sperm selection methods. However, MACS is more common in females under the age of 30, and PICSI is preferred in older females [ 7 ]. In conditions of unexplained infertility, methods for separating sperm with low DNA fragmentation can be utilized.…”

“…In conditions of unexplained infertility, methods for separating sperm with low DNA fragmentation can be utilized. The purpose of this study was to assess the efficacy of PICSI in patients with uncertain infertility [ 7 ]. Sperm quality has a significant role in controlling embryo growth and, consequently, the success of ICSI.…”

Assessment of the effectiveness of methods for the selection of sperm with increased DNA fragmentation in ART cycles

“…The DNA fragmentation index (DFI) has proven to be a beneficial biomarker in diagnosing male infertility. However, it is worth noting that more than 60% of men with unexplained infertility exhibit abnormalities in chromatin structure [5]. Therefore, in cases of unexplained infertility, analyzing sperm DNA can serve as an additional indicator of quality [6].…”