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Observational Study
. 2024 Aug;41(8):2201-2209.
doi: 10.1007/s10815-024-03168-9. Epub 2024 Jun 18.

Optimized sperm selection: a highly efficient device for the isolation of progressive motile sperm with low DNA fragmentation index

Ileana Mateizel  1 , Annalisa Racca  2 , Eleni Aligianni  3 , Elisa Distasi  4 , Yoni Baert  5   6 , Ingrid Segers  7 , Danijel Jankovic  7 , Celine Schoemans  7 , Koen Wouters  7 , Herman Tournaye  7 , Neelke De Munck  7
Affiliations
Observational Study

Optimized sperm selection: a highly efficient device for the isolation of progressive motile sperm with low DNA fragmentation index

Ileana Mateizel et al. J Assist Reprod Genet. 2024 Aug.

Abstract

Purpose: To identify the sperm preparation procedure that selects the best sperm population for medically assisted reproduction.

Methods: Prospective observational study comparing the effect of four different sperm selection procedures on various semen parameters. Unused raw semen after routine diagnostic analysis was split in four fractions and processed by four different methods: (1) density gradient centrifugation (DGC), (2) sperm wash (SW), (3) DGC followed by magnetic activated cell sorting (MACS), and (4) using a sperm separation device (SSD). Each fraction was analyzed for progressive motility, morphology, acrosome index (AI), and DNA fragmentation index (DFI).

Results: With DGC as standard of care in intraclass correlation coefficient analysis, only SSD was in strong disagreement regarding progressive motility and DFI [0.26, 95%CI (- 0.2, 0.58), and 0.17, 95%CI (- 0.19, 0.45), respectively]. When controlling for abstinence duration, DFI was significantly lower after both MACS and SSD compared to DGC [- 0.27%, 95%CI (- 0.47, - 0.06), p = 0.01, and - 0.6%, 95%CI (- 0.80, - 0.41), p < 0.001, respectively]. Further comparisons between SSD and MACS indicate significantly less apoptotic cells [Median (IQR) 4 (5), 95%CI (4.1, - 6.8) vs Median (IQR) 5 (8), 95%CI (4.9, - 9.2), p < 0.001, respectively] and dead cells [Median (IQR) 9.5 (23.3), 95%CI (13.2, - 22.4) vs Median (IQR) 22 (28), 95%CI (23.1, - 36.8), p < 0.001, respectively] in the SSD group.

Conclusion: The selection of a population of highly motile spermatozoa with less damaged DNA from unprocessed semen is ideally performed with SSD. Question remains whether this method improves the embryological outcomes in the IVF laboratory.

Keywords: DGC; FERTILE plus®; ICSI; MACS; Sperm; Sperm separation device.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Representative images from TUNEL assay and Tali apoptosis assay. A TUNEL assay for the detection of DNA fragmentation in human sperm under fluorescent microscopy. The sperm with intact DNA stained blue (white arrow) while the sperm displaying DNA fragmentation stained green (white asterisks). B Tali apoptosis assay for the detection of apoptotic, dead, and live cells. Apoptotic cells are labeled with Annexin V and stained green cells (black circles), dead cells are labeled with PI and stained red or stained with both PI and Annexin V and stained in orange (white circles), and live cells are unstained (white squares)
Fig. 2
Fig. 2
Capacity of MACS and SSD procedures to remove apoptotic (A) and dead (B) cells from sperm cell population (Wilcoxon signed-rank test). Spearman correlation test between the days of abstinence and the presence of dead cells in selected sperm population after MACS (C). Abbreviations: MACS: magnetic activated cell sorting, SSD: microfluidic sperm sorting
See this image and copyright information in PMC

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