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In cases with raised sperm DNA fragmentation, can sperm selection by magnetic-activated cell sorting or testicular sperm aspiration help improve reproductive outcomes?

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the efficacy of magnetic-activated cell sorting (MACS) or testicular sperm aspiration (TESA) to improve reproductive outcomes in cases with elevated sperm DNA fragmentation undergoing assisted reproduction.

Methods

This randomized controlled trial included couples with failed IVF cycles and sperm DNA fragmentation > 30%. Sperm DNA fragmentation was assessed using the sperm chromatin structure assay (SCSA) method. Participants were randomly assigned to either the MACS or TESA group. Testicular sperm retrieval was performed for the TESA group, while MACS involved sperm selection using magnetic beads. Extended blastocyst culture, freeze all policy of blastocysts by vitrification, and frozen embryo transfer were undertaken as per clinic’s standard operating protocols. Blastocyst formation rate, implantation rate, miscarriage rate, multiple pregnancy rate, and live birth rate were analyzed and compared between MACS and TESA groups.

Results

There were no significant differences in female age, male age, or sperm DNA fragmentation index (DFI) between the MACS and TESA groups. The blastocyst conversion rate was slightly higher in the TESA group (39%) compared to the MACS group (32%). However, the MACS group had a higher implantation rate (50%) than the TESA group (35%). Miscarriage rates, multiple pregnancy rates, and live birth rates did not show statistically significant differences between the groups. A chi-squared test was conducted to compare categorical variables, and t-tests were done to compare continuous variables.

Conclusion

In cases with raised sperm DNA fragmentation, sperm selection by MACS or TESA seems to offer comparable reproductive outcomes. There seems no superiority of one intervention over the other in cases with raised sperm DNA fragmentation undergoing assisted reproduction. Both interventions seem to be beneficial for couples seeking assisted reproduction with raised sperm DNA fragmentation.

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Data availability

The data that supports the findings of this research are not publicly available due to institutional restrictions. However, the datasets/tables/figures generated during this study or support the findings of the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank Dr. Mehul R. Chorawala and Ms. Sakshi Srivastava (Intas Pharmaceuticals Limited, Ahmedabad, India) for providing scientific writing assistance and follow-up with the editorial office of the journal. The authors are also grateful to Dr. Vishal Dave of Intas Pharmaceuticals Limited, Ahmedabad, India for the critical review of the manuscript at various stages.

Author information

Authors and Affiliations

  1. Department of Embryology, Oasis Fertility, Banjara Hills Road No. 2, Hyderabad, 500034, Telangana, India

    Krishna Chaitanya Mantravadi

  2. Department of Reproductive Endocrinology, Oasis Fertility, Banjara Hills Road No. 2, Hyderabad, 500034, Telangana, India

    Durga Rao

Authors
  1. Krishna Chaitanya Mantravadi
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Corresponding author

Correspondence to Krishna Chaitanya Mantravadi.

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All participants provided a written informed consent form to participate in the study.

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Consent for publication was obtained from all authors, the participants, or legally authorized representatives involved in this study.

Competing interest

The authors declare that they have no financial or non-financial or any other conflicts of interest related to this study. This study has no commercial interest in MACS technology and we have not received any funding or support from MACS technology company. The reason for choosing MACS is purely academic and scientific and not intended for any marketing or commercial purpose.

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Mantravadi, K.C., Rao, D. In cases with raised sperm DNA fragmentation, can sperm selection by magnetic-activated cell sorting or testicular sperm aspiration help improve reproductive outcomes?. J Assist Reprod Genet (2024). https://doi.org/10.1007/s10815-024-03128-3

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