Maria Luisa Pardiñas, Rocío Rivera-Egea, Jose Maria de Los Santos, Carmen Vidal, Juan Giles, David Ortega-Jaen, Julia Gil, Angel Martin, Thamara Viloria, Maria Jose de Los Santos
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引用次数: 0
Abstract
Objective: Determine the impact of a microfluidic-based sperm selection device on sperm parameters and embryo variables compared to the conventional swim-up method in sibling oocytes.
Design: Prospective observational study.
Subjects: A total of 345 oocytes were recruited from 27 couples undergoing intracytoplasmic sperm injection (ICSI), including both own (n=195) and donation (n=150) cycles. None of the patients presented severe male factor.
Intervention/exposure: Semen sample was divided into two groups and processed using (1) swim-up or (2) microfluidic sperm selection device (MSSD) ZyMōt. Half of the oocytes were inseminated with swim-up-selected spermatozoa, and the rest with MSSD-selected spermatozoa. Embryo development was followed by time-lapse. SDF was measured using sperm chromatin dispersion test, analyzed with ImageJ. A Mann-Whitney U test was performed for statistical analysis.
Main outcome measures: Sperm DNA fragmentation (SDF) levels, sperm parameters, fertilization rates, embryo morphokinetics and the rate of usable blastocysts.
Results: SDF was significantly lower in MSSD group compared to swim-up group (20.3% vs. 11%; P=0.004), indicating a better selection. Analyzing separately the oocytes from the patient's own cycles, MSSD showed a significantly higher rate of usable blastocysts per fertilized oocyte (P=0.041). However, this difference was not observed using donated oocytes or when both cycles were combined (P>0.05). Embryos from swim-up group showed a significant delay in time of pronuclei appearance (tPNa) and morula formation (tM) compared to MSSD group, being more marked in donated oocytes (P<0.05). No significant differences were observed in fertilization rate and the remaining morphokinetic times (P>0.05).
Conclusion: This study provides valuable information on the use of MSSD for non-invasive sperm selection. When MSSD was used, we have observed a reduction in SDF and an enhancement in the number of usable embryos in our own cycles. These findings could be compatible with a reduced capacity to repair sperm damage due to poorer oocyte quality caused by advanced age.
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