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Garrido N, Gil Juliá M. The Use of Non-Apoptotic Sperm Selected by Magnetic Activated Cell Sorting (MACS) to Enhance Reproductive Outcomes: What the Evidence Says. BIOLOGY 2024; 13:30. [PMID: 38248461 PMCID: PMC10813240 DOI: 10.3390/biology13010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/20/2023] [Accepted: 12/31/2023] [Indexed: 01/23/2024]
Abstract
Sperm selection of the most competent sperm is a promising way to enhance reproductive outcomes. Apoptosis is the programmed cell death process to maintain tissue homeostasis, and MACS sperm selection of non-apoptotic cells enables the removal of apoptotic sperm from an ejaculate, thus leaving the non-apoptotic available to be microinjected, but given the associated costs of adding these sperm selection steps to the routine practice, there is a need for a careful examination of the literature available to answer questions such as who can benefit from this MACS, how significant this improvement is, and how robust the evidence and data available supporting this choice are. Thus, the aim of this narrative review was to objectively evaluate the available evidence regarding the potential benefits of the use of MACS. From the literature, there are controversial results since its implementation as an in vitro fertilization add-on, and this may be explained in part by the low quality of the evidence available, wrong designs, or even inadequate statistical analyses. We concluded that the benefits of adding MACS are unclear, and further methodologically sound research on specific populations is much needed before offering it clinically.
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Affiliation(s)
- Nicolás Garrido
- IVIRMA Global Research Alliance, IVI Foundation, Andrology and Male Infertility Research Group, IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain;
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Gil Juliá M, Hervas I, Navarro-Gomezlechon A, Mossetti L, Quintana F, Amoros D, Pacheco A, Gonzalez-Ravina C, Rivera-Egea R, Garrido N. Semen processing using magnetic-activated cell sorting before ICSI is deemed safe for obstetric and perinatal outcomes: a retrospective multicentre study. Reprod Biomed Online 2023; 47:103172. [PMID: 37244866 DOI: 10.1016/j.rbmo.2023.01.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/20/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
RESEARCH QUESTION Is magnetic-activated cell sorting (MACS) a safe semen sample processing technique for newborns and mothers when used for semen processing prior to intracytoplasmic sperm injection (ICSI) cycles? DESIGN This retrospective multicentre cohort study involved patients undergoing ICSI cycles with either donor or autologous oocytes from January 2008 to February 2020. They were divided into two groups: those who underwent standard semen preparation (reference group) and those who had an added MACS procedure (MACS group). A total of 25,356 deliveries were assessed in the case of cycles using donor oocytes, and 19,703 deliveries from cycles using autologous oocytes. Of these, 20,439 and 15,917, respectively, were singleton deliveries. Obstetric and perinatal outcomes were retrospectively assessed. All means, rates and incidences were computed per live newborn in each study group. RESULTS There were no significant differences between the main obstetric and perinatal morbidities affecting the mothers' and newborns' well-being between groups using either donated or autologous oocytes. There was a significant increase in the incidence of gestational anaemia in both subpopulations (donor oocytes P = 0.01; autologous oocytes P < 0.001). However, this incidence was within the estimated prevalence for gestational anaemia in the general population. There was a statistically significant decrease in preterm (P = 0.02) and very preterm (P = 0.01) birth rates in the MACS group in cycles using donor oocytes. CONCLUSIONS The use of MACS during semen preparation before ICSI using either donor or autologous oocytes appears to be safe for the mothers' and newborns' well-being during pregnancy and birth. Nevertheless, a close follow-up of these parameters in the future is advised, especially concerning anaemia, in order to detect even smaller effect sizes.
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Affiliation(s)
- María Gil Juliá
- IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
| | - Irene Hervas
- IVI Foundation, Health Research Institute La Fe, Valencia, Spain; IVIRMA Roma Casilino, Rome, Italy
| | | | - Laura Mossetti
- IVI Foundation, Health Research Institute La Fe, Valencia, Spain; IVIRMA Roma Casilino, Rome, Italy
| | | | | | | | | | | | - Nicolas Garrido
- IVI Foundation, Health Research Institute La Fe, Valencia, Spain
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Analyzing the Differential Impact of Semen Preparation Methods on the Outcomes of Assisted Reproductive Techniques. Biomedicines 2023; 11:biomedicines11020467. [PMID: 36831003 PMCID: PMC9953211 DOI: 10.3390/biomedicines11020467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
Sperm separation plays a critical role in assisted reproductive technology. Based on migration, density gradient centrifugation and filtration, a properly selected sperm could help in increasing assisted reproductive outcomes in teratozoospermia (TZs). The current study aimed to assess the prognostic value of four sperm selection techniques: density gradient centrifugation (DGC), swim-up (SU), DGC-SU and DGC followed by magnetic-activated cell sorting (DGC-MACS). These were evaluated using spermatozoa functional parameters. A total of 385 infertile couples underwent the procedure of intracytoplasmic sperm injection (ICSI), with an isolated teratozoospermia in the male partner. Semen samples were prepared by using one of the mentioned sperm preparation techniques. The improvements in the percentage of normal mature spermatozoa, rate of fertilization, cleavage, pregnancy and the number of live births were assessed. The normal morphology, spermatozoa DNA fragmentation (SDF) and chromatin maturity checked by using chromomycin A3 (CMA3) with DGC-MACS preparation were better compared to the other three methods. Embryo cleavage, clinical pregnancy and implantation were better improved in the DGC-MACS than in the other tested techniques. The DGC-MACS technique helped in the selection of an increased percentage of normal viable and mature sperm with intact chromatin integrity in patients with teratozoospermia.
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Bisla A, Honparkhe M, Srivastava N. A review on applications and toxicities of metallic nanoparticles in mammalian semen biology. Andrologia 2022; 54:e14589. [DOI: 10.1111/and.14589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 08/14/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Amarjeet Bisla
- Department of Veterinary Gynaecology and Obstetrics, College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences University Ludhiana India
| | - Mrigank Honparkhe
- Department of Veterinary Gynaecology and Obstetrics, College of Veterinary Science Guru Angad Dev Veterinary and Animal Sciences University Ludhiana India
| | - Neeraj Srivastava
- Germ Plasm Centre, Division of Animal Reproduction ICAR‐Indian Veterinary Research Institute Bareilly India
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Pacheco A, Blanco A, Bronet F, Cruz M, García-Fernández J, García-Velasco JA. Magnetic-Activated Cell Sorting (MACS): A Useful Sperm-Selection Technique in Cases of High Levels of Sperm DNA Fragmentation. J Clin Med 2020; 9:jcm9123976. [PMID: 33302575 PMCID: PMC7763893 DOI: 10.3390/jcm9123976] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 01/19/2023] Open
Abstract
Magnetic-activated cell sorting (MACS) can be used to separate apoptotic sperm with high proportions of fragmented DNA from the rest, thus improving the overall quality of the seminal sample. Therefore, the aim of this retrospective study was to investigate the efficiency of the MACS technique to increase reproductive outcomes in patients with high levels of sperm DNA fragmentation (SDF) undergoing intracytoplasmic sperm-injection (ICSI) cycles. In this study, we analyzed a total of 724 assisted-reproduction-technique (ART) cycles that were divided into two groups: the study group (n = 366) in which the MACS selection technique was performed after density-gradient centrifugation (DGC), and the control group (n = 358) in which only DGC was used for sperm selection. Reproductive outcomes were analyzed in both groups according to three different ART procedures: preimplantation genetic testing for aneuploidy (PGT-A), and autologous and oocyte-donation cycles. The MACS group showed significantly lower miscarriage rates in autologous ICSI cycles, higher pregnancy rates in oocyte-donation cycles, and a significant increase in live-birth rates in both autologous and oocyte-donation cycles. Overall, these results suggested that the MACS technique can be effectively used to eliminate sperm with high SDF levels, and therefore may help to improve reproductive outcomes in couples undergoing ART.
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Affiliation(s)
- Alberto Pacheco
- IVI Madrid, 28023 Madrid, Spain; (F.B.); (M.C.); (J.A.G.-V.)
- Science Faculty, Alfonso X “El Sabio” University, Villanueva de la Cañada, 28691 Madrid, Spain
- Correspondence: ; Tel.: +34-911-802-900
| | | | - Fernando Bronet
- IVI Madrid, 28023 Madrid, Spain; (F.B.); (M.C.); (J.A.G.-V.)
| | - María Cruz
- IVI Madrid, 28023 Madrid, Spain; (F.B.); (M.C.); (J.A.G.-V.)
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Daneshmandpour Y, Pashazadeh F, Ansari F, Hosseinifard H, Nouri M, Yousefi M, Sakhinia E. The comparative effect of magnetic activated cell sorting, density gradient centrifugation and swim up on assisted reproduction outcomes, sperm DNA fragmentation, and aneuploidy: A systematic review and meta-analysis. Meta Gene 2019. [DOI: 10.1016/j.mgene.2019.100607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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El Fekih S, Tous C, Gueganic N, Brugnon F, Ali HB, Bujan L, Moinard N, Caire-Tetauru E, Ajina M, Douet-Guilbert N, Morel F, Perrin A. Decrease of spermatozoa with an unbalanced chromosome content after cell sorting in men carrying a structural chromosomal abnormality. Andrology 2019; 8:181-190. [PMID: 31116011 DOI: 10.1111/andr.12643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND We showed that in men with a constitutional chromosomal abnormality, DNA fragmentation was significantly higher in chromosomally unbalanced spermatozoa than in spermatozoa with a normal or balanced chromosomal content. These results could be explained by a phenomenon already described in infertile men: abortive apoptosis. OBJECTIVES To determine whether magnetic-activated cell separation could select spermatozoa with lower levels of DNA fragmentation and unbalanced chromosome content in men carrying a structural chromosomal abnormality. MATERIALS AND METHODS The spermatozoa of ten males with a chromosomal rearrangement were separated into two populations using magnetic-activated cell separation (annexin V (-) and annexin V (+) fractions), in order to study meiotic segregation by fluorescence in situ hybridization, the percentage of spermatozoa with an externalization of phosphatidylserine by annexin V staining and DNA fragmentation by TdT-mediated dUTP nick-end labeling on the whole ejaculate and on selected spermatozoa in the same patient. RESULTS For all patients, the percentage of spermatozoa with externalization of phosphatidylserine decreased in the annexin V (-) fraction and increased in the annexin V (+) fraction as compared to the frozen-thawed semen sample. The rates of DNA fragmentation were statistically much lower in the annexin V (-) fraction when compared to the rate before magnetic-activated cell separation for all but one patient. Conversely, we observed a statistically significantly higher rate of DNA fragmentation in the annexin V (+) fraction for six patients. After magnetic-activated cell separation, there was a significant increase of normal/balanced spermatozoa in the fraction of annexin V (-) for all patients. Conversely, we observed a significant decrease in the fraction of annexin V (+) for seven patients. DISCUSSION AND CONCLUSIONS Magnetic-activated cell separation is a promising tool for increasing the selection of healthy spermatozoa, with a decrease in the number of spermatozoa with externalization of phosphatidylserine, DNA fragmentation, and chromosome unbalance, for use in assisted reproductive technologies such as intracytoplasmic sperm injection for males with a chromosomal structural abnormality.
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Affiliation(s)
- S El Fekih
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Laboratoire de Cytogénétique, Génétique Moléculaire et Biologie de la Reproduction Humaines, CHU Farhat Hached Sousse et Université de Monastir, Monastir, Tunisie
| | - C Tous
- Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - N Gueganic
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France
| | - F Brugnon
- CHU Clermont-Ferrand, AMP, CECOS, Clermont-Ferrand, France.,Faculté de Médecine, IMOST, INSERM 1240, Clermont-Ferrand, France
| | - H Ben Ali
- Laboratoire de Cytogénétique, Génétique Moléculaire et Biologie de la Reproduction Humaines, CHU Farhat Hached Sousse et Université de Monastir, Monastir, Tunisie
| | - L Bujan
- Groupe de Recherche en Fertilité Humaine, EA 3694, Groupe d'activité de Médecine de la Reproduction, Université Paul Sabatier et CECOS, CHU Toulouse, France
| | - N Moinard
- Groupe de Recherche en Fertilité Humaine, EA 3694, Groupe d'activité de Médecine de la Reproduction, Université Paul Sabatier et CECOS, CHU Toulouse, France
| | - E Caire-Tetauru
- Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - M Ajina
- Unité de Médecine de la Reproduction, CHU Farhat Hached, Sousse, Tunisie
| | - N Douet-Guilbert
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - F Morel
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
| | - A Perrin
- Laboratoire d'histologie, Embryologie et Cytogénétique, INSERM U1078, Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France.,Service de Cytogénétique et Biologie de la Reproduction, CHRU Morvan, Brest, France
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Jeyendran RS, Caroppo E, Rouen A, Anderson A, Puscheck E. Selecting the most competent sperm for assisted reproductive technologies. Fertil Steril 2019; 111:851-863. [DOI: 10.1016/j.fertnstert.2019.03.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/18/2019] [Accepted: 03/18/2019] [Indexed: 12/27/2022]
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Štiavnická M, Abril-Parreño L, Nevoral J, Králíčková M, García-Álvarez O. Non-Invasive Approaches to Epigenetic-Based Sperm Selection. Med Sci Monit 2017; 23:4677-4683. [PMID: 28961228 PMCID: PMC5633068 DOI: 10.12659/msm.904098] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Since sperm size and form do not necessarily provide information on internal sperm structures, novel sperm markers need to be found in order to conduct assisted reproductive therapies (ART) successfully. Currently, the priority of andrologists is not only to select those sperm able to fertilize the oocyte, but also a high quality of sperm that will guarantee a healthy embryo. Evidence of this shows us the importance of studying sperm intensively on genetic and epigenetic levels, because these could probably be the cause of a percentage of infertility diagnosed as idiopathic. Thus, more attention is being paid to posttranslational modifications as the key for better understanding of the fertilization process and its impact on embryo and offspring. Advances in the discovery of new sperm markers should go hand in hand with finding appropriate techniques for selecting the healthiest sperm, guaranteeing its non-invasiveness. To date, most sperm selection techniques can be harmful to sperm due to centrifugation or staining procedures. Some methods, such as microfluidic techniques, sperm nanopurifications, and Raman spectroscopy, have the potential to make selection gentle to sperm, tracking small abnormalities undetected by methods currently used. The fact that live cells could be analyzed without harmful effects creates the expectation of using them routinely in ART. In this review, we focus on the combination of sperm epigenetic status (modifications) as quality markers, with non-invasive sperm selection methods as novel approaches to improve ART outcomes.
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Affiliation(s)
- Miriama Štiavnická
- Laboratory of Reproductive Medicine of Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Laura Abril-Parreño
- Laboratory of Reproductive Medicine of Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jan Nevoral
- Laboratory of Reproductive Medicine of Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Milena Králíčková
- Laboratory of Reproductive Medicine of Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Olga García-Álvarez
- Laboratory of Reproductive Medicine of Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
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Meseguer M, Pellicer A. What else can we do? The latest attempt to improve the sperm's path. Fertil Steril 2017; 108:444-445. [PMID: 28865541 DOI: 10.1016/j.fertnstert.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/06/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Marcos Meseguer
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
| | - Antonio Pellicer
- Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain
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Jeve YB, Potdar N, Blower JA, Gelbaya T. Strategies to improve fertilisation rates with assisted conception: a systematic review. HUM FERTIL 2017; 21:229-247. [PMID: 28545312 DOI: 10.1080/14647273.2017.1324182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Successful fertilisation is one of the key steps determining success of assisted conception. Various factors including sperm or oocyte pathology and environmental factors have a significant impact on fertilisation rates. This systematic review is aimed to evaluate the existing evidence about factors affecting fertilisation and strategies to improve fertilisation rates. A literature search was performed using Ovid MEDLINE ® (Jan 1950-April 2016), EMBASE (Jan 1950-April 2016), Ovid OLDMEDLINE ®, Pre-MEDLINE (Jan 1950-April 2016) and the Cochrane Library. Relevant key words were used to combine sets of results and a total 243 papers were screened. Only qualitative analysis was performed, as there was major heterogeneity in study design and methodology for quantitative synthesis. Factors affecting fertilisation were divided into sperm- and oocyte-related factors. The methods to improve fertilisation rates were grouped together based on the approach used to improve fertilisation rates. Optimising laboratory condition and procedural effects in techniques is associated with improved fertilisation rates. Various techniques are described to improve fertilisation rates including assisted oocyte activation, physiological intracytoplasmic sperm injection (PICSI) and intracytoplasmic morphologically selected sperm injection (IMSI). This review highlights the promising strategies under research to enhance fertilisation rates. Adequately powered multicentre randomised trials are required to evaluate these techniques before considering clinical application.
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Affiliation(s)
- Yadava Bapurao Jeve
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK
| | - Neelam Potdar
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK.,b Reproductive Sciences Section , University of Leicester , Leicester , UK
| | - Jane A Blower
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK
| | - Tarek Gelbaya
- a Leicester Fertility Centre , University Hospitals of Leicester , Leicester , UK
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