Sperm Selection by Magnetic-Activated Cell Sorting before Microinjection of Autologous Oocytes Increases Cumulative Live Birth Rates with Limited Clinical Impact: A Retrospective Study in Unselected Males

Abstract

The application of MACS non-apoptotic sperm selection in infertility clinics is controversial since the published literature does not agree on its effect on reproductive outcomes. Therefore, it is not part of the routine clinical practice. Classical measures of reproductive success (pregnancy or live birth rates per ovarian stimulation) introduce a bias in the evaluation of a technique’s effect, since only the best embryo is transferred. This retrospective, multicenter, observational study evaluated the impact of MACS on reproductive outcomes, measuring results in classical parameters and cumulative live birth rates (CLBR). Data from ICSI cycles using autologous oocyte in Spanish IVIRMA fertility clinics from January 2008 to February 2020 were divided into two groups according to their semen processing: standard practice (reference: 46,807 patients) versus an added MACS sperm selection (1779 patients). Only when measured as CLBR per embryo transferred and per MII oocyte used was the difference between groups statistically significant. There were no significant differences between MACS and reference groups on pregnancy and live birth rates. In conclusion, results suggest that non-apoptotic sperm selection by MACS on unselected males prior to ICSI with autologous oocytes has limited clinical impact, showing a subtle increase in CLBR per embryo transferred.

Effect of Sperm Selection by Magnetic-Activated Cell Sorting in D-IUI: A Randomized Control Trial

“…For this reason, it has been proposed in several studies that MACS could contribute to the improvement of ART clinical outcomes [ 15 , 16 , 17 , 18 ]. However, over the years, no consensus on whether this technique provides any additional benefit over ARTs has been reached [ 19 ].…”

“…However, over the years, no consensus on whether this technique provides any additional benefit over ARTs has been reached [ 19 ]. This could be due to the differences in the study designs and the diversity of the profiles of patients taking part in these research works [ 15 ]. Although some advantage in sperm parameters have been reported, it is still inconclusive whether MACS procedure is valuable for clinical practice and in which patients it should be applied.…”

The reproductive success of Simmental bovine after sex-sorting under various incubation and centrifugation protocols

“…Conception rate was obtained to measure NRR by calculating the percentage of pregnant cows after insemination using non-sexed sperm, X-bearing sperm, and Y-bearing sperm without centrifugation (n = 15) (A0, A1, and A2) and non-sexed sperm, X-bearing sperm, and Y-bearing sperm with centrifugation (n = 15) (B0, B1, and B2) in the first insemination of the total number of cattle inseminated. The data collected were calculated using the formula [ 12 ]:…”

“…Service per conception was obtained by determining the number of straws used and the number of pregnant females. The data collected were calculated using the formula [ 12 ]:…”

The Combined Impact of Female and Male Body Mass Index on Cumulative Pregnancy Outcomes After the First Ovarian Stimulation

“…Next, because of the inherent limitations of retrospective data, we were unable to set an exclusion criterion that was strictly standard for males, which may contribute to selection bias. In addition, we did not have information about sperm, which is a potential confounder affecting the CLBR (22).…”