Effects of the microfluidic chip technique in sperm selection for intracytoplasmic sperm injection for unexplained infertility: a prospective, randomized controlled trial

Abstract

Purpose The new-generation spermatozoon selection method, microfluidic technique called Fertile Chip ® gives the chance to select spermatozoa with lower DNA fragmentation indexes. We aimed to determine the effect of microfluidic techniques for spermatozoon selection in ICSI treatment in patients with unexplained infertility. Methods This prospective randomized controlled study was conducted at a university hospital. One hundred twenty-two couples with unexplained infertility were included, in which 61 of them were treated with conventional swim-up techniques (control group) and another 61 with the microfluidic technique (study group) for spermatozoon selection in IVF treatment. The fertilization rates and the quality of embryos were the primary outcomes, and clinical pregnancy (CPR) and live birth rates (LBR) were the secondary outcomes of our study.Results CPR in the study group and control group were 48.3% and 44.8% (p = 0.35) and LBR were 38.3% and 36.2% (p = 0.48), respectively. The fertilization rates were similar (63.6% and 57.4%, p = 0.098). A total number of grade 1 embryos were significantly higher in microfluidic technique group than in control group (1.45 ± 1.62 vs. 0.83 ± 1.03, p = 0.01). There were more surplus top quality embryos leftover to freeze in the study group (0.71 ± 1.48 vs. 0.22 ± 0.69, p = 0.02). Conclusion Our study showed that the microfluidic technique does not change fertilization, CPR, and LBR during IVF treatment for couples with unexplained infertility. Despite the fact that the total number of grade 1 embryos after ICSI treatment and the surplus number of grade 1 embryos after embryo transfer were higher in the microfluidic technique group, the study was not powered to detect this difference. Trial registration NCT02488434

Use of microfluidic sperm extraction chips as an alternative method in patients with recurrent in vitro fertilisation failure

“…In our study, we tested whether sperm cells using the Fertile Plus chips create a difference compared with the gradient method in the selection of best sperms in terms of morphological and genomic integrity and success of pregnancy in microinjection (ICSI) cycles. A recent study comparing swim-up and microfluidic chip methods in IVF patients with unknown reasons reports that there was no difference between pregnancy and fertilisation rates [11]. In our study, we used gradient method instead of the swim-up method and we, too, failed to observe any difference between the two methods in pregnancy rates.…”

Does a microfluidic chip for sperm sorting have a positive add‐on effect on laboratory and clinical outcomes of intracytoplasmic sperm injection cycles? A sibling oocyte study

“…In the current literature, there is only one published study that reports the effects of using microfluidic chips for sperm selection in ICSI cycles compared with conventional swim‐up method among cases with unexplained infertility (Yetkinel et al, ). The data of this study showed that fertilisation rates were found to be comparable between groups; but, a number of grade 1 embryos were found to be significantly higher in microfluidic group.…”

“…However, the most important question whether their use is of any advantage in terms of laboratory and clinical IVF/ICSI outcomes still remains controversy. In the literature, there is only one study evaluating clinical data following the use of a commercial microfluidic chip (Fertile Plus ® ; Koek Biotechnology) for ICSI cycles who were suffering from unexplained infertility; they found that a number of grade 1 embryos were found to be significantly higher in microfluidic group resulting in a higher rate of embryo freezing despite comparable fertilisation ratios (Yetkinel et al, ).…”

Novel Techniques of Sperm Selection for Improving IVF and ICSI Outcomes

“…Due to the novelty of these methodologies, there is only one study that employs the selected spermatozoa in ARTs. In a recent publication in which spermatozoa were selected from 122 patients with infertility of unknown etiology using a commercial microfluidic device (61 patients) (Fertile Chip ® , KOEK Biotechnology, Turkey) or by SU (61 patients), no differences were found in terms of fertilization, pregnancy, and live birth rates during ICSI between both sperm selection methods (Yetkinel et al, 2019). However, these authors observed a higher quality in those embryos produced with spermatozoa selected by Fertile Chip ® .…”