1
|
Jahangiri AR, Ziarati N, Dadkhah E, Bucak MN, Rahimizadeh P, Shahverdi A, Sadighi Gilani MA, Topraggaleh TR. Microfluidics: The future of sperm selection in assisted reproduction. Andrology 2024; 12:1236-1252. [PMID: 38148634 DOI: 10.1111/andr.13578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 11/03/2023] [Accepted: 12/10/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Obtaining functional sperm cells is the first step to treat infertility. With the ever-increasing trend in male infertility, clinicians require access to effective solutions that are able to single out the most viable spermatozoa, which would max out the chance for a successful pregnancy. The new generation techniques for sperm selection involve microfluidics, which offers laminar flow and low Reynolds number within the platforms can provide unprecedented opportunities for sperm selection. Previous studies showed that microfluidic platforms can provide a novel approach to this challenge and since then researchers across the globe have attacked this problem from multiple angles. OBJECTIVE In this review, we seek to provide a much-needed bridge between the technical and medical aspects of microfluidic sperm selection. Here, we provide an up-to-date list on microfluidic sperm selection procedures and its application in assisted reproductive technology laboratories. SEARCH METHOD A literature search was performed in Web of Science, PubMed, and Scopus to select papers reporting microfluidic sperm selection using the keywords: microfluidic sperm selection, self-motility, non-motile sperm selection, boundary following, rheotaxis, chemotaxis, and thermotaxis. Papers published before March 31, 2023 were selected. OUTCOMES Our results show that most studies have used motility-based properties for sperm selection. However, microfluidic platforms are ripe for making use of other properties such as chemotaxis and especially rheotaxis. We have identified that low throughput is one of the major hurdles to current microfluidic sperm selection chips, which can be solved via parallelization. CONCLUSION Future work needs to be performed on numerical simulation of the microfluidics chip prior to fabrication as well as relevant clinical assessment after the selection procedure. This would require a close collaboration and understanding among engineers, biologists, and medical professionals. It is interesting that in spite of two decades of microfluidics sperm selection, numerical simulation and clinical studies are lagging behind. It is expected that microfluidic sperm selection platforms will play a major role in the development of fully integrated start-to-finish assisted reproductive technology systems.
Collapse
Affiliation(s)
- Ali Reza Jahangiri
- NanoLund, Lund University, Lund, Sweden
- Materials Science and Applied Mathematics, Malmö University, Malmö, Sweden
| | - Niloofar Ziarati
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ehsan Dadkhah
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mustafa Numan Bucak
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Pegah Rahimizadeh
- Division of Experimental Surgery, McGill University, Montreal, Quebec, Canada
- Cancer Research Program, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Tohid Rezaei Topraggaleh
- Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
- Department of Anatomical Sciences, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
2
|
Vahedi Raad M, Firouzabadi AM, Tofighi Niaki M, Henkel R, Fesahat F. The impact of mitochondrial impairments on sperm function and male fertility: a systematic review. Reprod Biol Endocrinol 2024; 22:83. [PMID: 39020374 PMCID: PMC11253428 DOI: 10.1186/s12958-024-01252-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/27/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Besides adenine triphosphate (ATP) production for sustaining motility, the mitochondria of sperm also host other critical cellular functions during germ cell development and fertilization including calcium homeostasis, generation of reactive oxygen species (ROS), apoptosis, and in some cases steroid hormone biosynthesis. Normal mitochondrial membrane potential with optimal mitochondrial performance is essential for sperm motility, capacitation, acrosome reaction, and DNA integrity. RESULTS Defects in the sperm mitochondrial function can severely harm the fertility potential of males. The role of sperm mitochondria in fertilization and its final fate after fertilization is still controversial. Here, we review the current knowledge on human sperm mitochondria characteristics and their physiological and pathological conditions, paying special attention to improvements in assistant reproductive technology and available treatments to ameliorate male infertility. CONCLUSION Although mitochondrial variants associated with male infertility have potential clinical use, research is limited. Further understanding is needed to determine how these characteristics lead to adverse pregnancy outcomes and affect male fertility potential.
Collapse
Affiliation(s)
- Minoo Vahedi Raad
- Department of Biology & Anatomical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Masoud Firouzabadi
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Physiology, School of Medical Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Tofighi Niaki
- Health Reproductive Research Center, Sari Branch, Islamic Azad University, Sari, Iran
| | - Ralf Henkel
- LogixX Pharma, Theale, Berkshire, UK.
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa.
| | - Farzaneh Fesahat
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| |
Collapse
|
3
|
Cariati F, Orsi MG, Bagnulo F, Del Mondo D, Vigilante L, De Rosa M, Sciorio R, Conforti A, Fleming S, Alviggi C. Advanced Sperm Selection Techniques for Assisted Reproduction. J Pers Med 2024; 14:726. [PMID: 39063980 PMCID: PMC11278480 DOI: 10.3390/jpm14070726] [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: 05/06/2024] [Revised: 06/30/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
Male infertility accounts for approximately 40% of infertility cases. There are many causes of male infertility, including environmental factors, age, lifestyle, infections, varicocele, and cancerous pathologies. Severe oligozoospermia, cryptozoospermia, and azoospermia (obstructive and non-obstructive) are identified as severe male factor infertility, once considered conditions of sterility. Today, in vitro fertilization (IVF) techniques are the only treatment strategy in cases of male factor infertility for which new methodologies have been developed in the manipulation of spermatozoa to achieve fertilization and increase success rates. This review is an update of in vitro manipulation techniques, in particular sperm selection, emphasizing clinical case-specific methodology. The success of an IVF process is related to infertility diagnosis, appropriate choice of treatment, and effective sperm preparation and selection. In fact, selecting the best spermatozoa to guarantee an optimal paternal heritage means increasing the blastulation, implantation, ongoing pregnancy and live birth rates, resulting in the greater success of IVF techniques.
Collapse
Affiliation(s)
- Federica Cariati
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (L.V.); (M.D.R.); (C.A.)
- Fertility Unit, Maternal-Child Department, AOU Federico II Polyclinic, 80131 Naples, Italy;
| | - Maria Grazia Orsi
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.G.O.); (A.C.)
| | - Francesca Bagnulo
- Fertility Unit, Maternal-Child Department, AOU Federico II Polyclinic, 80131 Naples, Italy;
| | - Daniela Del Mondo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy;
| | - Luigi Vigilante
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (L.V.); (M.D.R.); (C.A.)
- Fertility Unit, Maternal-Child Department, AOU Federico II Polyclinic, 80131 Naples, Italy;
| | - Martina De Rosa
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (L.V.); (M.D.R.); (C.A.)
- Fertility Unit, Maternal-Child Department, AOU Federico II Polyclinic, 80131 Naples, Italy;
| | - Romualdo Sciorio
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman Mother Child, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Alessandro Conforti
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy; (M.G.O.); (A.C.)
| | - Steven Fleming
- Discipline of Anatomy & Histology, School of Medical Sciences, University of Sydney, Sydney, NSW 2050, Australia;
| | - Carlo Alviggi
- Department of Public Health, School of Medicine, University of Naples Federico II, 80131 Naples, Italy; (F.C.); (L.V.); (M.D.R.); (C.A.)
- Fertility Unit, Maternal-Child Department, AOU Federico II Polyclinic, 80131 Naples, Italy;
| |
Collapse
|
4
|
Godiwala P, Kwieraga J, Almanza E, Neuber E, Grow D, Benadiva C, Makhijani R, DiLuigi A, Schmidt D, Bartolucci A, Engmann L. The impact of microfluidics sperm processing on blastocyst euploidy rates compared with density gradient centrifugation: a sibling oocyte double-blinded prospective randomized clinical trial. Fertil Steril 2024; 122:85-94. [PMID: 38367686 DOI: 10.1016/j.fertnstert.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE To compare the euploidy rates among blastocysts created from sibling oocytes injected with sperm and processed using microfluidics or density gradient centrifugation. DESIGN Sibling oocyte randomized controlled trial. SETTING Single university-affiliated infertility practice. PATIENTS A total of 106 patients aged 18-42 years undergoing fresh in vitro fertilization treatment cycles with preimplantation genetic testing between January 2021 and April 2022 contributed 1,442 mature oocytes, which were injected with sperm and processed using microfluidics or density gradient centrifugation. INTERVENTION(S) The sperm sample is divided and processed using a microfluidics device and density gradient centrifugation for injection into sibling oocytes. MAIN OUTCOME MEASURE(S) The primary outcome was the embryo euploidy rate. Secondary outcomes included fertilization, high-quality blastulation, and ongoing pregnancy rates. RESULT(S) The blastocyst euploidy rate per mature oocyte was not significantly different in the study group compared with the control group (22.9% vs. 20.5%). The blastocyst euploidy rate per biopsied embryo was also similar between the 2 groups (53.0% vs. 45.7%). However, the fertilization rate per mature oocyte injected was found to be significantly higher in the study group compared with the control group (76.0% vs. 69.9%). The high-quality blastulation rate per mature oocyte injected was similar between the 2 groups, as was the total number of embryos frozen. There were no differences in the number of participants with no blastocysts for biopsy or the number of participants with no euploid embryos between the 2 groups. Among the male factor infertility and recurrent pregnancy loss subgroups, there were no differences in euploidy rates, fertilization rates, blastulation rates, or total numbers of blastocysts frozen, although the study was underpowered to detect these differences. Seventy-seven patients underwent frozen embryo transfer; there were no significant differences in pregnancy outcomes between the 2 groups. CONCLUSION(S) Microfluidics processing did not improve embryo euploidy rates compared with density gradient centrifugation in this sibling oocyte study, although fertilization rates were significantly higher. CLINICAL TRIAL REGISTRATION NUMBER NCT04744025.
Collapse
Affiliation(s)
- Prachi Godiwala
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Jane Kwieraga
- The Center for Advanced Reproductive Services, Farmington, Connecticut
| | - Emilse Almanza
- Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Evelyn Neuber
- The Center for Advanced Reproductive Services, Farmington, Connecticut
| | - Daniel Grow
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Claudio Benadiva
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Reeva Makhijani
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Andrea DiLuigi
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - David Schmidt
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Alison Bartolucci
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Lawrence Engmann
- The Center for Advanced Reproductive Services, Farmington, Connecticut; Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, Connecticut.
| |
Collapse
|
5
|
Banti M, Van Zyl E, Kafetzis D. Sperm Preparation with Microfluidic Sperm Sorting Chip May Improve Intracytoplasmic Sperm Injection Outcomes Compared to Density Gradient Centrifugation. Reprod Sci 2024; 31:1695-1704. [PMID: 38393626 PMCID: PMC11111481 DOI: 10.1007/s43032-024-01483-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Does sperm preparation using the FERTILE PLUS™ Sperm Sorting Chip improve fertilization rates, blastocyst formation, utilization, and euploidy rates in patients undergoing intracytoplasmic sperm injection (ICSI), compared with density gradient centrifugation (DGC)? A single-cohort, retrospective data review including data from 53 couples who underwent ICSI cycles within a 12-month period. For each couple, the two closest, consecutive cycles were identified, where one used the standard technique of sperm preparation (DGC) and the subsequent used FERTILE PLUS™, therefore, couples acted as their own controls. Paired samples t-test was used to compare means for the outcomes (fertilization, blastocyst formation, utilization, and euploidy rates). Binary logistic regression analysis assessed the relationship between female age, the presence of male factor infertility, and euploidy rates. Blastocyst, utilization, and euploidy rates were significantly higher for cycles using FERTILE PLUS™ compared to DGC (76% vs 56%, p = 0.002; 60% vs 41%, p = 0.005, and 40% vs 20%, p = 0.001, respectively). Although there was an increase in fertilization rates for cycles using FERTILE PLUS™, this was not significant (72% vs 68%, p = 0.449). The euploidy rates of females ≤ 35 years were significantly increased when the FERTILE PLUS™ sperm preparation method was used, compared to the older age group (OR 2.31, p = 0.007). No significant association was found between the presence or absence of male factor infertility and euploidy rates between the two cycles. This study provides tentative evidence that the FERTILE PLUS™ microfluidic sorting device for sperm selection can improve blastocyst formation, utilization, and euploidy rates following ICSI in comparison to the DGC method.
Collapse
Affiliation(s)
- Maria Banti
- Orchid Reproductive & Andrology Services, Dubai Healthcare City, Unit 4016, Block E, Al Razi Bldg #64, Dubai, UAE.
| | - Estee Van Zyl
- Orchid Reproductive & Andrology Services, Dubai Healthcare City, Unit 4016, Block E, Al Razi Bldg #64, Dubai, UAE
| | - Dimitrios Kafetzis
- Orchid Reproductive & Andrology Services, Dubai Healthcare City, Unit 4016, Block E, Al Razi Bldg #64, Dubai, UAE
| |
Collapse
|
6
|
Godiwala P, Kwieraga J, Neuber E, Yohe MS, Bartolucci A, Engmann L. Rationale and study design of a double-blinded prospective randomized clinical trial comparing euploidy rates among embryos created from sibling oocytes injected with sperm processed by microfluidics or by density gradient centrifugation. Contemp Clin Trials 2022; 120:106893. [PMID: 36007710 DOI: 10.1016/j.cct.2022.106893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/19/2022] [Accepted: 08/19/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND During the in vitro fertilization (IVF) process, sperm must be processed prior to insemination. While the most common method, density gradient centrifugation, can potentially damage sperm during centrifugation, a recent advancement in sperm processing uses a microfluidics system which selects for the most highly motile sperm. In selecting for these sperm which may be of higher quality, the euploidy rates of embryos created as a result may also be improved. The primary aim of this study is to compare the euploidy rates per mature oocyte between embryos created from sibling oocytes injected with sperm processed by microfluidics sorting or by density gradient centrifugation. METHODS This is a double-blinded prospective randomized sibling oocyte study including patients undergoing treatment with IVF with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing (PGT). After controlled ovarian hyperstimulation, oocytes from each patient will be separated into two groups. Each group will be randomized to sperm processed using either microfluidics or density gradient centrifugation and embryos biopsied for PGT to assess euploidy rates. A sample size of 686 oocytes in each group for a total of 1372 oocytes will provide 80% power to detect a significant difference in the euploidy rates per mature oocyte between the two groups. An ancillary study examining the relationship between sperm processing method and sperm DNA fragmentation will be assessed. CONCLUSION This study will offer insight into the sperm's contribution to embryo euploidy, and has the potential to provide an alternative method of improving euploidy rates in clinical practice.
Collapse
Affiliation(s)
- Prachi Godiwala
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America
| | - Jane Kwieraga
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America
| | - Evelyn Neuber
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America
| | - Michael Scott Yohe
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America
| | - Alison Bartolucci
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America
| | - Lawrence Engmann
- The Center for Advanced Reproductive Services, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, Farmington, CT 06032, United States of America.
| |
Collapse
|