P-120 Microfluidic sperm selection device increases clinical pregnancy rate in IVF/ PGT-A cycles

Abstract

Study question Evaluate the influence of sperm selection according to the sorting technique, and its effects in clinical and laboratory parameters in IVF/PGT-A cycles. Summary answer Cycles that used microfluidic sperm selection device presented an increase in clinical pregnancy rates. What is known already A common genomic anomaly detected in subfertile men is the Sperm DNA fragmentation. It is resulted of a high concentation of free radicals produced causing oxidative stress in sperm cells. In order to achieve a normal embryonic development is necessary good spermatozoa with intact genetic material. In fact, embryonic quality parameters as lower fertilization, blastocyst formation and pregnancy rates has been related with Sperm DNA fragmentation increased cases. The microfluidic sperm selection device has been commercialized promising to select spermatozoa with a low level of DNA fragmentation and suggest a relationship between embryo quality, euploidy and pregnancy rates. Study design, size, duration A case-control study involving 494 IVF/PGT-A cycles that resulted in embryo biopsy between June, 2020 and November, 2021 at a Brazilian private practice unit (Instituto Ideia Fertil) were included in this analysis. Participants/materials, setting, methods All cycles that would perform PGT-A were splitted in two groups considering the sperm sorting technique: case - Microfluidic sperm selection device (245 cycles) and control - Density gradient centrifugation + swim-up (249 cycles) were included. The variables considered in this analysis were patient age, sperm concentration, fertilization, D3 top quality, blastocyst top quality, blastulation, ploidy and pregnancy rates. This data were analysed between groups and female age (until 37; 38-40 and over 41). Main results and the role of chance The mean age of the female and male patients found were 38.05 and 38.2 respectively and there was not statistically significant different between groups. Fertilization rate compared between case (72.4%) and control (76.5%) groups (p < 0.05) demonstrated statistically significant difference, but when stratified accordingly to the age, only the female age until 37 years old group showed significant difference (73.25%; 76.43%; p < 0.05). The variables analyzed as D3 Top Quality, Blastocyst Top Quality, blastulation and ploidy did not present difference (p = 0.552; 0.699; 0.378). The clinical pregnancy rate analyzed revealed in case group 65.33% and control 56.38% (p < 0.05), demonstrating statistically significant difference. When groups were splitted according to the female age (until 37 years old; 38-40 and over 41) the findings behaved in the same characteristics, increasing only the clinical pregnancy rate. The tests used was Mann-Whitney and Kruskal-wallis. Limitations, reasons for caution The DNA fragmentation test was not evaluated because not all patients had this test performed. Besides that, another parameter that will be analysed is live birth rate. Wider implications of the findings Microfluidic sperm sorting device made possible to select high quality spermatozoa according to motility, morphology, and low rates of fragmentation, showing the importance of having a good sperm in clinical pregnancy rate. Trial registration number none