High Pregnancy and Implantation Rates Can Be Obtained Using Magnetic-Activated Cell Sorting (MACS) to Selection Spermatozoa in Patients with High Levels of Spermatic DNA Fragmentation

Abstract

Purpose: DNA fragmentation in spermatozoa has been associated with poor semen quality, low fertilization rates, impaired preimplantation development, and high miscarriage rates. The objective of this study was to evaluate the effects of the use of non-apoptotic MACS-selected spermatozoa in ICSI cycles, compared to those ICSI cycles in patients with normal sperm DNA fragmentation. Methods: A total of 134 cycles of ICSI were included in the study. The study group consisted of patients with high DNA fragmentation and their spermatozoa were selected by MACS (n=57); and the control group, of patients with normal DNA fragmentation and their spermatozoa were selected by classic morphological characteristics. The fertilization rate, cleavage rate, embryo quality, pregnancy rate (PR), implantation rate (IR) and miscarriage rate (MR) were compared between groups. Results: There was no difference in the fertilization rate (74.5 and 76.5%), cleavage rate and good embryo quality at Day 3 (98.3 and 89.1%; 88.4 and 83.7%) or blastocyst formation rate (50.8 and 41.1%) for the study and control groups, respectively. PRs, IRs and MRs were similar for the study group compared to the control group (PR: 63.2 versus 45.5%; IR: 37.4 versus 28.1%; MR: 8.3 versus 17.1). The women were distributed into three groups: <35 years, 35-39 years and ≥ 40 years. Pregnancy, implantation and miscarriage rates were similar in the three evaluated groups (P: NS). Conclusions: By selecting non-apoptotic sperm by MACS, we can achieve very acceptable pregnancy and implantation rates; being a good option for couples with high sperm DNA fragmentation and repeated assisted reproduction failures.