#204 : First Recorded Normal Live Birth After ICSI with Electrophoretically Isolated Spermatozoa Using the Felix™ System

Abstract

Background and Aims: This report describes the first live birth with sperm isolated using the Felix™ system. Methods: Thirty-three couples undergoing ovarian stimulation were recruited based on high raw semen DNA Fragmentation Index (DFI) of >20%, as assessed by the sperm chromatin structure assay. The Felix™ system, which isolates sperm based on charge and size was used as the sperm preparation method, over a six-minute interval. Mature oocytes were injected using Intracytoplasmic Sperm Injection (ICSI). Normally fertilised zygotes were cultured until day three or five. Suitable embryos were vitrified and subsequently transferred in a frozen embryo cycle. Biochemical pregnancy was determined by plasma human chorionic gonadotrophin level of >20 IU and clinical pregnancy was determined by the presence of fetal heat and/or sac on ultrasound. Miscarriage and live births rates were also recorded. Results: Raw semen concentration, progressive motility and total motility levels were in the normal range according to 6[Formula: see text] World Health Organisation criteria. However, sperm DFI was relatively high (range 20% to 80%). The average age of females was 30 years (range 21 to 44). A total of 374 oocytes were collected from the 33 females, with 266 mature oocytes then injected by ICSI. This resulted in 83% fertilisation rate and embryo utilisation of 65%. Four females underwent single embryo transfer, and 29 females underwent double embryo transfer. Of those, 19 (58%) biochemical pregnancies were achieved resulting in 14 (42%) ongoing clinical pregnancies. Three miscarriages and two normal live births have been reported to date. Interestingly, the two live births resulted from men of DFI of 80% and 33%. Conclusion: This report describes the first birth after sperm isolated using the Felix™ system followed by ICSI. The Felix™ system is an efficient procedure to prepare sperm and has the potential to be advantageous for patients with high DFI.