Effect of sperm selection using MACS technology in the PGT-A program compared with standard sperm preparation

Abstract

To compare the blastocysts available for biopsy, euploid rates and reproductive outcomes in embryos incubated in a time-lapse system, when MACS technology for sperm selection was applied or not. Secondary analysis from a prospective trial. 500 patients were distributed in two groups: MACS n=245 (Swim-up + MACS) vs. Control group n=255 before ICSI treatment. With the use of Time-lapse technology, we did a complete embryo follow-up until blastocyst biopsy with further morphokinetic analysis. 1600 blastocyst were biopsied 716 (42.7%) in the group of MACS and 884 (52.0%) in the control group reaching statistical significance with a p valor < 0.001. The percentage of euploid blastocysts in each group was 42.2% in MACS group and 38.1% in control group without statistical significance. Similar results were obtained in all the parameters compared between groups, number of embryo transferred with 0.85 (CI95%0.6-1.1) vs 1.0 (CI95%0.5-1.5) and implantation rates of 38.6%(CI95%18.2-59.1) vs. 55.6%(CI95% 30.1-81.0) in MACS group compared with control group. We observed an inverse and significant correlation, related to the MACS technology application, in the proportion of blastocysts available for biopsy, but this effect was not detected when we analyzed the number of euploid blastocysts in each group. Similar data was obtained in outcome reproductive results. All these results suggest that MACS technology does not have any effect on PGT-A outcome when performed. Our results are supported by a consistent sample size.