Magnetic-activated cell sorting of nonapoptotic spermatozoa with a high DNA fragmentation index improves the live birth rate and decreases transfer cycles of IVF/ICSI

Mei, Jie; Chen, Lin-Jun; Zhu, Xinxin; Yao, Wen; Gao, Qiang; Sun, Haixiang; Ding, Lijun; Wang, Junxia

doi:10.4103/aja202161

Cited by 12 publications

(6 citation statements)

References 31 publications

(33 reference statements)

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“…, 2022 ). In contrast, in a prospective cohort study, including 80 males with DFI ≥30%, no difference in CPR was found with the use of MACS ( Mei etal. , 2022 ).…”

Section: Resultsmentioning

confidence: 88%

Good practice recommendations on add-ons in reproductive medicine

Lundin,

Bentzen,

Bozdag

et al. 2023

Human Reproduction

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STUDY QUESTION Which add-ons are safe and effective to be used in ART treatment? SUMMARY ANSWER Forty-two recommendations were formulated on the use of add-ons in the diagnosis of fertility problems, the IVF laboratory and clinical management of IVF treatment. WHAT IS KNOWN ALREADY The innovative nature of ART combined with the extremely high motivation of the patients has opened the door to the wide application of what has become known as ‘add-ons’ in reproductive medicine. These supplementary options are available to patients in addition to standard fertility procedures, typically incurring an additional cost. A diverse array of supplementary options is made available, encompassing tests, drugs, equipment, complementary or alternative therapies, laboratory procedures, and surgical interventions. These options share the common aim of stating to enhance pregnancy or live birth rates, mitigate the risk of miscarriage, or expedite the time to achieving pregnancy. STUDY DESIGN, SIZE, DURATION ESHRE aimed to develop clinically relevant and evidence-based recommendations focusing on the safety and efficacy of add-ons currently used in fertility procedures in order to improve the quality of care for patients with infertility. PARTICIPANTS/MATERIALS, SETTING, METHODS ESHRE appointed a European multidisciplinary working group consisting of practising clinicians, embryologists, and researchers who have demonstrated leadership and expertise in the care and research of infertility. Patient representatives were included in the working group. To ensure that the guidelines are evidence-based, the literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, recommendations were based on the professional experience and consensus of the working group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 46 independent international reviewers. A total of 272 comments were received and incorporated where relevant. MAIN RESULTS AND THE ROLE OF CHANCE The multidisciplinary working group formulated 42 recommendations in three sections; diagnosis and diagnostic tests, laboratory tests and interventions, and clinical management. LIMITATIONS, REASONS FOR CAUTION Of the 42 recommendations, none could be based on high-quality evidence and only four could be based on moderate-quality evidence, implicating that 95% of the recommendations are supported only by low-quality randomized controlled trials, observational data, professional experience, or consensus of the development group. WIDER IMPLICATIONS OF THE FINDINGS These guidelines offer valuable direction for healthcare professionals who are responsible for the care of patients undergoing ART treatment for infertility. Their purpose is to promote safe and effective ART treatment, enabling patients to make informed decisions based on realistic expectations. The guidelines aim to ensure that patients are fully informed about the various treatment options available to them and the likelihood of any additional treatment or test to improve the chance of achieving a live birth. STUDY FUNDING/COMPETING INTEREST(S) All costs relating to the development process were covered from ESHRE funds. There was no external funding of the development process or manuscript production. K.L. reports speakers fees from Merck and was part of a research study by Vitrolife (unpaid). T.E. reports consulting fees from Gynemed, speakers fees from Gynemed and is part of the scientific advisory board of Hamilton Thorne. N.P.P. reports grants from Merck Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA and Besins Healthcare, speakers fees from Merck Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA and Besins Healthcare. S.R.H. declares being managing director of Fertility Europe, a not-for-profit organization receiving financial support from ESHRE. I.S. is a scientific advisor for and has stock options from Alife Health, is co-founder of IVFvision LTD (unpaid) and received speakers’ fee from the 2023 ART Young Leader Prestige workshop in China. A.P. reports grants from Gedeon Richter, Ferring Pharmaceuticals and Merck A/S, consulting fees from Preglem, Novo Nordisk, Ferring Pharmaceuticals, Gedeon Richter, Cryos and Merck A/S, speakers fees from Gedeon Richter, Ferring Pharmaceuticals, Merck A/S, Theramex and Organon, travel fees from Gedeon Richter. The other authors disclosed no conflicts of interest. DISCLAIMER This Good Practice Recommendations (GPRs) document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and are based on the scientific evidence available at the time of preparation. ESHRE GPRs should be used for information and educational purposes. They should not be interpreted as setting a standard of care or bedeemedinclusive of all proper methods of care, or be exclusive of other methods of care reasonably directed to obtaining the same results.Theydo not replace the need for application of clinical judgement to each individual presentation, or variations based on locality and facility type. Furthermore, ESHRE GPRs do not constitute or imply the endorsement, or favouring, of any of the included technologies by ESHRE.

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“…, 2022 ). In contrast, in a prospective cohort study, including 80 males with DFI ≥30%, no difference in CPR was found with the use of MACS ( Mei etal. , 2022 ).…”

Section: Resultsmentioning

confidence: 88%

Good practice recommendations on add-ons in reproductive medicine

Lundin,

Bentzen,

Bozdag

et al. 2023

Human Reproduction

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“…Ziarati et al [73] showed increased number of superior embryos and clinical pregnancies when performing DGC + MACS than DGC alone in a study of 80 infertile couples suffering from male factor [73]. In the study by Mei et al [74], selection of nonapoptotic spermatozoa by MACS for higher sperm DFI was found to improve the live birth rate and decrease transfer cycles of IVF/ICSI [74]. Our study suggests that DGC + MACS can be performed before freezing for infertile males suffering from low-quality sperm to optimize the outcomes of ICSI.…”

Section: Discussionmentioning

confidence: 98%

Density Gradient Centrifugation Alone or the Combination of DGC with Annexin V Magnetic-Activated Cell Sorting Prior to Cryopreservation Enhances the Postthaw Quality of Sperm from Infertile Male Patients with Poor Sperm Quality

et al. 2023

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Objective. To examine whether density gradient centrifugation (DGC) alone or its combination with annexin V magnetic-activated cell sorting (DGC-MACS) can be used to process semen samples from infertile male patients with poor sperm quality prior to subjecting these to freeze/thaw process in order to optimize the outcomes of sperm freezing. Methods. This study enrolled sixteen patients with sperm concentration ≥ 20 × 10 6 / mL , sperm motility < 30 %, and/or <4% normal sperm morphology. Sperms were processed by DGC or DGC-MACS prior to the freeze/thaw process. Sperm motility, hyperosmotic swelling test (HOS), TUNEL test, and morphological analysis were performed before and after the freeze/thaw process. Results. The freeze/thaw process had a detrimental effect on sperm motility, viability, morphology, and DNA integrity in all three groups (RAW, DGC, and DGC + MACS groups). The DGC and DGC + MACS groups showed increased sperm motility, viability, and normal morphology following freeze/thaw than untreated frozen controls. The motility and viability were not significantly different between DGC-MACS-CPT (cryopreservation-thawing) and DGC-CPT groups. Moreover, almost no grade A or grade B sperm was observed in the DGC-MACS-CPT groups. The sperm selected by DGC or DGC + MACS showed decreased levels of sperm DNA fragmentation than RAW samples following freeze/thaw. Moreover, the sperm DNA fragmentation following freeze/thaw in the DGC-MACS-CPT group was significantly lower than that in the DGC-CPT group. Conclusions. Sperm preparation by DGC before cryopreservation improved the quality of sperm postthaw in infertile males with poor sperm quality. If the sperm quality following freeze/thaw is foreseen to be insufficient for artificial insemination with husband’s sperm or in vitro fertilization, or if there is high DNA fragmentation in RAW sperm, DGC + MACS should be used prior to cryopreservation to reduce sperm DNA fragmentation and improve the quality of sperm available for intracytoplasmic sperm injection.

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“…During sperm preparation, MACS is a procedure that separates spermatozoa with externalized PS utilizing annexin V-conjugated microbead technology [ 12 ]. The sensitivity of the sperm to DNA fragmentation can also demonstrate the lack of a DNA repair mechanism.…”

Section: Discussionmentioning

confidence: 99%

Management of Primary Infertility: A Comprehensive Approach With Magnetic-Activated Cell Sorting in an Asthenozoospermic Patient

Tyagi,

More,

Chaudhary

et al. 2024

Cureus

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This report presents the cases of a 34-year-old male and a 29-year-old female who visited a fertility clinic and were experiencing primary infertility for the past three years. No previous medical history was identified in the couple. After a failed attempt of intrauterine insemination, the male partner was diagnosed with asthenozoospermia. A second attempt of intracytoplasmic sperm injection (ICSI) was performed which failed again. Subsequently, magnetic-activated cell sorting (MACS) technique was used as the sperm selection technique. The male patient’s sperms were selected through MACS before ICSI. After performing MACS, successful pregnancy was achieved, which resulted in the production of blastocysts and a positive beta-human chorionic gonadotropin test. This case report highlights the prospect of successful results, despite the presence of sperm DNA fragmentation, and a comprehensive strategy for managing infertility issues. Promoting knowledge of lifestyle factors and how they affect fertility remains an essential aspect of comprehensive infertility care.

show abstract

Magnetic-activated cell sorting of nonapoptotic spermatozoa with a high DNA fragmentation index improves the live birth rate and decreases transfer cycles of IVF/ICSI

Cited by 12 publications

References 31 publications

Good practice recommendations on add-ons in reproductive medicine

Good practice recommendations on add-ons in reproductive medicine

Density Gradient Centrifugation Alone or the Combination of DGC with Annexin V Magnetic-Activated Cell Sorting Prior to Cryopreservation Enhances the Postthaw Quality of Sperm from Infertile Male Patients with Poor Sperm Quality

Management of Primary Infertility: A Comprehensive Approach With Magnetic-Activated Cell Sorting in an Asthenozoospermic Patient

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