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
|
Mateizel I, Racca A, Aligianni E, Distasi E, Baert Y, Segers I, Jankovic D, Schoemans C, Wouters K, Tournaye H, De Munck N. Optimized sperm selection: a highly efficient device for the isolation of progressive motile sperm with low DNA fragmentation index. J Assist Reprod Genet 2024; 41:2201-2209. [PMID: 38890266 PMCID: PMC11339219 DOI: 10.1007/s10815-024-03168-9] [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: 12/07/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
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.
Collapse
Affiliation(s)
- Ileana Mateizel
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium.
| | - Annalisa Racca
- Department of Reproductive Medicine, Instituto Bernabeu Venice, Martellago, Italy
| | - Eleni Aligianni
- School of Medicine, Kapodistrian University of Athens, Athens, Greece
| | - Elisa Distasi
- Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy
| | - Yoni Baert
- Department of In Vitro Toxicology and Dermato-Cosmetology (IVTD), Vrije Universiteit Brussel, Brussels, Belgium
- Biology of the Testis (BITE), Department of Genetics, Reproduction and Development (GRAD), Vrije Universiteit Brussel, Brussels, Belgium
| | - Ingrid Segers
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium
| | - Danijel Jankovic
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium
| | - Celine Schoemans
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium
| | - Koen Wouters
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium
| | - Herman Tournaye
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium
| | - Neelke De Munck
- Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels IVF, Brussels, Belgium
| |
Collapse
|
3
|
Meseguer F, Giménez Rodríguez C, Rivera Egea R, Carrión Sisternas L, Remohí JA, Meseguer M. Can Microfluidics Improve Sperm Quality? A Prospective Functional Study. Biomedicines 2024; 12:1131. [PMID: 38791093 PMCID: PMC11118748 DOI: 10.3390/biomedicines12051131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
The same sperm selection techniques in assisted reproduction clinics have remained largely unchanged despite their weaknesses. Recently, microfluidic devices have emerged as a novel methodology that facilitates the sperm selection process with promising results. A prospective case-control study was conducted in two phases: 100 samples were used to compare the microfluidic device with Density Gradient, and another 100 samples were used to compare the device with the Swim-up. In the initial phase, a significant enhancement in progressive motility, total progressive motile sperm count, vitality, morphology, and sperm DNA fragmentation were obtained for the microfluidic group compared to Density Gradient. Nevertheless, no statistically significant differences were observed in sperm concentration and chromatin structure stability. In the subsequent phase, the microfluidic group exhibited significant increases in sperm concentration, total progressive motile sperm count, and vitality compared to Swim-up. However, non-significant differences were seen for progressive motility, morphology, DNA structure stability, and DNA fragmentation. Similar trends were observed when results were stratified into quartiles. In conclusion, in a comparison of microfluidics with standard techniques, an improvement in sperm quality parameters was observed for the microfluidic group. However, this improvement was not significant for all parameters.
Collapse
Affiliation(s)
- Fernando Meseguer
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
| | - Carla Giménez Rodríguez
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| | - Rocío Rivera Egea
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
| | - Laura Carrión Sisternas
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| | - Jose A. Remohí
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| | - Marcos Meseguer
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| |
Collapse
|
4
|
Bouloorchi Tabalvandani M, Saeidpour Z, Habibi Z, Javadizadeh S, Firoozabadi SA, Badieirostami M. Microfluidics as an emerging paradigm for assisted reproductive technology: A sperm separation perspective. Biomed Microdevices 2024; 26:23. [PMID: 38652182 DOI: 10.1007/s10544-024-00705-2] [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] [Accepted: 04/08/2024] [Indexed: 04/25/2024]
Abstract
Millions of people are subject to infertility worldwide and one in every six people, regardless of gender, experiences infertility at some period in their life, according to the World Health Organization. Assisted reproductive technologies are defined as a set of procedures that can address the infertility issue among couples, culminating in the alleviation of the condition. However, the costly conventional procedures of assisted reproduction and the inherent vagaries of the processes involved represent a setback for its successful implementation. Microfluidics, an emerging tool for processing low-volume samples, have recently started to play a role in infertility diagnosis and treatment. Given its host of benefits, including manipulating cells at the microscale, repeatability, automation, and superior biocompatibility, microfluidics have been adopted for various procedures in assisted reproduction, ranging from sperm sorting and analysis to more advanced processes such as IVF-on-a-chip. In this review, we try to adopt a more holistic approach and cover different uses of microfluidics for a variety of applications, specifically aimed at sperm separation and analysis. We present various sperm separation microfluidic techniques, categorized as natural and non-natural methods. A few of the recent developments in on-chip fertilization are also discussed.
Collapse
Affiliation(s)
| | - Zahra Saeidpour
- MEMS Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, 1439957131, Iran
| | - Zahra Habibi
- MEMS Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, 1439957131, Iran
| | - Saeed Javadizadeh
- MEMS Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, 1439957131, Iran
| | - Seyed Ahmadreza Firoozabadi
- MEMS Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, 1439957131, Iran
| | - Majid Badieirostami
- MEMS Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, 1439957131, Iran.
| |
Collapse
|
5
|
Montjean D, Godin Pagé MH, Pacios C, Calvé A, Hamiche G, Benkhalifa M, Miron P. Automated Single-Sperm Selection Software (SiD) during ICSI: A Prospective Sibling Oocyte Evaluation. Med Sci (Basel) 2024; 12:19. [PMID: 38651413 PMCID: PMC11036211 DOI: 10.3390/medsci12020019] [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: 12/21/2023] [Revised: 02/27/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024] Open
Abstract
The computer-assisted program SiD was developed to assess and select sperm in real time based on motility characteristics. To date, there are limited studies examining the correlation between AI-assisted sperm selection and ICSI outcomes. To address this limit, a total of 646 sibling MII oocytes were randomly divided into two groups as follows: the ICSI group (n = 320): ICSI performed with sperm selected by the embryologist and the ICSI-SiD group (n = 326): ICSI performed with sperm selected using SiD software. Our results show a non-significant trend towards improved outcomes in the ICSI-SiD group across various biological parameters, including fertilization, cleavage, day 3 embryo development, blastocyst development, and quality on day 5. Similarly, we observed a non-significant increase in these outcomes when comparing both groups with sperm selection performed by a junior embryologist. Embryo development was monitored using a timelapse system. Some fertilization events happen significantly earlier when SiD is used for ICSI, but no significant difference was observed in the ICSI-SiD group for other timepoints. We observed comparable cumulative early and clinical pregnancy rates after ICSI-SiD. This preliminary investigation illustrated that employing the automated sperm selection software SiD leads to comparable biological outcomes, suggesting its efficacy in sperm selection.
Collapse
Affiliation(s)
- Debbie Montjean
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
| | - Marie-Hélène Godin Pagé
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
| | - Carmen Pacios
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
| | - Annabelle Calvé
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
| | - Ghenima Hamiche
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
| | - Moncef Benkhalifa
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
- Médecine et Biologie de la Reproduction, CECOS de Picardie et Laboratoire PERITOX, Université Picardie Jules Verne, CBH-CHU Amiens Picardie, 1 Rond-Point du Professeur Christian Cabrol, 80054 Amiens, France
| | - Pierre Miron
- Centre d’aide médicale à la procréation Fertilys, 1950 Maurice-Gauvin Street, Laval, QC H7S 1Z5, Canada; (M.-H.G.P.); (C.P.)
- Médecine et Biologie de la Reproduction, CECOS de Picardie et Laboratoire PERITOX, Université Picardie Jules Verne, CBH-CHU Amiens Picardie, 1 Rond-Point du Professeur Christian Cabrol, 80054 Amiens, France
| |
Collapse
|
6
|
Lundin K, Bentzen JG, Bozdag G, Ebner T, Harper J, Le Clef N, Moffett A, Norcross S, Polyzos NP, Rautakallio-Hokkanen S, Sfontouris I, Sermon K, Vermeulen N, Pinborg A. Good practice recommendations on add-ons in reproductive medicine†. Hum Reprod 2023; 38:2062-2104. [PMID: 37747409 PMCID: PMC10628516 DOI: 10.1093/humrep/dead184] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
STUDY QUESTION Which add-ons are safe and effective to be used in ART treatment? SUMMARY ANSWER Forty-two recommendations were formulated on the use of add-ons in the diagnosis of fertility problems, the IVF laboratory and clinical management of IVF treatment. WHAT IS KNOWN ALREADY The innovative nature of ART combined with the extremely high motivation of the patients has opened the door to the wide application of what has become known as 'add-ons' in reproductive medicine. These supplementary options are available to patients in addition to standard fertility procedures, typically incurring an additional cost. A diverse array of supplementary options is made available, encompassing tests, drugs, equipment, complementary or alternative therapies, laboratory procedures, and surgical interventions. These options share the common aim of stating to enhance pregnancy or live birth rates, mitigate the risk of miscarriage, or expedite the time to achieving pregnancy. STUDY DESIGN, SIZE, DURATION ESHRE aimed to develop clinically relevant and evidence-based recommendations focusing on the safety and efficacy of add-ons currently used in fertility procedures in order to improve the quality of care for patients with infertility. PARTICIPANTS/MATERIALS, SETTING, METHODS ESHRE appointed a European multidisciplinary working group consisting of practising clinicians, embryologists, and researchers who have demonstrated leadership and expertise in the care and research of infertility. Patient representatives were included in the working group. To ensure that the guidelines are evidence-based, the literature identified from a systematic search was reviewed and critically appraised. In the absence of any clear scientific evidence, recommendations were based on the professional experience and consensus of the working group. The guidelines are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines were reviewed by 46 independent international reviewers. A total of 272 comments were received and incorporated where relevant. MAIN RESULTS AND THE ROLE OF CHANCE The multidisciplinary working group formulated 42 recommendations in three sections; diagnosis and diagnostic tests, laboratory tests and interventions, and clinical management. LIMITATIONS, REASONS FOR CAUTION Of the 42 recommendations, none could be based on high-quality evidence and only four could be based on moderate-quality evidence, implicating that 95% of the recommendations are supported only by low-quality randomized controlled trials, observational data, professional experience, or consensus of the development group. WIDER IMPLICATIONS OF THE FINDINGS These guidelines offer valuable direction for healthcare professionals who are responsible for the care of patients undergoing ART treatment for infertility. Their purpose is to promote safe and effective ART treatment, enabling patients to make informed decisions based on realistic expectations. The guidelines aim to ensure that patients are fully informed about the various treatment options available to them and the likelihood of any additional treatment or test to improve the chance of achieving a live birth. STUDY FUNDING/COMPETING INTEREST(S) All costs relating to the development process were covered from ESHRE funds. There was no external funding of the development process or manuscript production. K.L. reports speakers fees from Merck and was part of a research study by Vitrolife (unpaid). T.E. reports consulting fees from Gynemed, speakers fees from Gynemed and is part of the scientific advisory board of Hamilton Thorne. N.P.P. reports grants from Merck Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA and Besins Healthcare, speakers fees from Merck Serono, Ferring Pharmaceutical, Theramex, Gedeon Richter, Organon, Roche, IBSA and Besins Healthcare. S.R.H. declares being managing director of Fertility Europe, a not-for-profit organization receiving financial support from ESHRE. I.S. is a scientific advisor for and has stock options from Alife Health, is co-founder of IVFvision LTD (unpaid) and received speakers' fee from the 2023 ART Young Leader Prestige workshop in China. A.P. reports grants from Gedeon Richter, Ferring Pharmaceuticals and Merck A/S, consulting fees from Preglem, Novo Nordisk, Ferring Pharmaceuticals, Gedeon Richter, Cryos and Merck A/S, speakers fees from Gedeon Richter, Ferring Pharmaceuticals, Merck A/S, Theramex and Organon, travel fees from Gedeon Richter. The other authors disclosed no conflicts of interest. DISCLAIMER This Good Practice Recommendations (GPRs) document represents the views of ESHRE, which are the result of consensus between the relevant ESHRE stakeholders and are based on the scientific evidence available at the time of preparation.ESHRE GPRs should be used for information and educational purposes. They should not be interpreted as setting a standard of care or bedeemedinclusive of all proper methods of care, or be exclusive of other methods of care reasonably directed to obtaining the same results.Theydo not replace the need for application of clinical judgement to each individual presentation, or variations based on locality and facility type.Furthermore, ESHRE GPRs do not constitute or imply the endorsement, or favouring, of any of the included technologies by ESHRE.
Collapse
Affiliation(s)
| | - K Lundin
- Department Reproductive Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
| | - J G Bentzen
- The Fertility Department, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - G Bozdag
- Department Obstetrics and Gynecology, Koc University School of Medicine, Istanbul, Turkey
| | - T Ebner
- Department of Gynecology, Obstetrics, and Gynecological Endocrinology, Kepler University, MedCampus IV, Linz, Austria
| | - J Harper
- Institute for Women’s Health, London, UK
| | - N Le Clef
- European Society of Human Reproduction and Embryology, Brussels, Belgium
| | - A Moffett
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | - N P Polyzos
- Department Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | | | | | - K Sermon
- Research Group Reproduction and Genetics, Vrije Universiteit Brussel, Brussels, Belgium
| | - N Vermeulen
- European Society of Human Reproduction and Embryology, Brussels, Belgium
| | - A Pinborg
- The Fertility Department, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
7
|
Shukla SK, Gaudriault P, Corbera A. Lab-on-chip (LoC) application for quality sperm selection: An undelivered promise? OPEN RESEARCH EUROPE 2023; 3:188. [PMID: 38645796 PMCID: PMC11031645 DOI: 10.12688/openreseurope.16671.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 04/23/2024]
Abstract
Quality sperm selection is essential to ensure the effectiveness of assisted reproductive techniques (ART). However, the methods employed for sperm selection in ART often yield suboptimal outcomes, contributing to lower success rates. In recent years, microfluidic devices have emerged as a promising avenue for investigating the natural swimming behavior of spermatozoa and developing innovative approaches for quality sperm selection. Despite their potential, the commercial translation of microfluidic-based technologies has remained limited. This comprehensive review aims to critically evaluate the inherent potential of lab-on-chip technology in unraveling sophisticated mechanisms encompassing rheotaxis, thermotaxis, and chemotaxis. By reviewing the current state-of-the-art associated with microfluidic engineering and the swimming of spermatozoa, the goal is to shed light on the multifaceted factors that have impeded the broader commercialization of these cutting-edge technologies and recommend a commercial that can surmount the prevailing constraints. Furthermore, this scholarly exploration seeks to enlighten and actively engage reproductive clinicians in the profound potential and implications of microfluidic methodologies within the context of human infertility.
Collapse
Affiliation(s)
- Shiva K Shukla
- Research and Development Unit, Beez Biotech SAS, RENNES, Ille-et-Villain, 35000, France
| | - Pierre Gaudriault
- Research and Development Unit, Cherry Biotech SAS, Paris, 93100, France
| | - Antoni Corbera
- Research and Development Unit, Cherry Biotech SAS, Paris, 93100, France
| |
Collapse
|
8
|
Vigolo V, Gautier C, Falomo ME, Aurich C. Selection of frozen-thawed stallion semen by microfluidic technology. Reprod Domest Anim 2023; 58:443-449. [PMID: 36510754 DOI: 10.1111/rda.14305] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/07/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022]
Abstract
The use of microfluidic technology is increasing in artificial reproduction technologies: With a small amount of semen, it allows for the selection of sperm with the best characteristics of kinetics, morphology and chromatin integrity. The ZyMot Multi (850 μl) is the most popular device of ZyMot Fertility Inc. To date, it was proven to be a valid instrument for sperm selection for in vitro fertilization and intracytoplasmic sperm injection in men. The aim of this study was to test the efficacy of the ZyMot Multi (850 μl) for stallion semen. Frozen-thawed semen from 15 stallions that were previously classified as being of 'good fertility' (GF; n = 8; pregnancy rate ≥ 40%) and 'poor fertility' (PF; n = 7; pregnancy rate < 20%), respectively, was used. Each ejaculate was assessed before and after microfluid recovery for kinetics (CASA), membrane integrity (MI) (SYBR14/PI), membrane functionality (MF) (HOS test), acrosome integrity (Spermac Stain Kit), morphology (Spermac stain kit), mitochondrial membrane potential (MMP) (JC-1) and chromatin integrity (aniline blue staining). Sperm concentration was reduced after sperm recovery in both groups, but more markedly in frozen-thawed semen of PF stallions (p < .05). Microfluid recovery increased total motility, MI, MF and MMP. While there was a significant increase in the percentage of progressively motile sperm after sperm microfluid recovery, there was a decrease in DAP, DSL, VAP, VSL, LIN, WOB and ALH (p < .05). A slight increase (p < .05) was detected in beat-cross frequency. The present results suggest that the ZyMot Multi (850 μl) device selects a specific sperm population from any stallion ejaculate with motile sperm and could therefore be a valid tool for in vitro testing with the aim to predict the fertility of frozen-thawed stallion semen.
Collapse
Affiliation(s)
- Veronica Vigolo
- Department for Small Animals and Horses, Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Vienna, Austria.,Department of Animal Medicine, Production and Health (MAPS), Università di Padova, Legnaro (PD), Italy
| | - Camille Gautier
- Department for Small Animals and Horses, Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Vienna, Austria
| | - Maria Elena Falomo
- Department of Animal Medicine, Production and Health (MAPS), Università di Padova, Legnaro (PD), Italy
| | - Christine Aurich
- Department for Small Animals and Horses, Artificial Insemination and Embryo Transfer, Vetmeduni Vienna, Vienna, Austria
| |
Collapse
|
9
|
Sperm DNA Damage and Its Relevance in Fertility Treatment: A Review of Recent Literature and Current Practice Guidelines. Int J Mol Sci 2023; 24:ijms24021446. [PMID: 36674957 PMCID: PMC9860847 DOI: 10.3390/ijms24021446] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 01/14/2023] Open
Abstract
Sperm deoxyribonucleic acid (DNA) damage has recently emerged as one of the most controversial topics in male reproductive medicine. While level I evidence indicates that abnormal sperm DNA damage has substantial adverse effects on reproductive outcomes (including chance of pregnancy and risk of miscarriage), there is limited consensus on how sperm DNA fragmentation (SDF) testing should be performed and/or interpreted in clinical practice. In this article, we review: (1) how SDF is assessed, (2) cumulative evidence regarding its impact on reproductive outcomes, (3) methods for mitigating high SDF, and (4) the most recent practice guidelines available for clinicians regarding the use and interpretation of SDF testing.
Collapse
|
10
|
Schardein JN, Fendereski K, Hotaling JM. Evolution of the basic semen analysis and processing sperm. Curr Opin Urol 2023; 33:16-23. [PMID: 36226727 DOI: 10.1097/mou.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The sixth edition of the World Health Organization (WHO) laboratory manual for the examination and processing of human semen was recently published with specific step-by-step instructions for semen evaluation and sperm processing. Point-of-care (POC) testing for semen evaluation and microfluidics for sperm processing are rapidly evolving technologies that could impact how we evaluate and process sperm. Understanding the updated manual in the context of these novel technologies is important. RECENT FINDINGS Proper standardization of semen evaluation and sperm processing will allow for consistent high-quality results among laboratories worldwide. POC testing could improve access to semen evaluations that generate referrals to male infertility specialists for further assessment. Microfluidics can select functional sperm with decreased DNA fragmentation in semen and testicular biopsy samples for assisted reproductive technology (ART). Clinical outcomes, such as pregnancy rates and live birth rates, have not been shown to be consistently improved with these technologies compared to conventional techniques, although high level evidence research in this area is limited. SUMMARY POC testing and microfluidics have the potential to be combined with machine learning technologies to improve fertility care. If these technologies are appropriately optimized, they could change how we evaluate and process sperm, and potentially lead to improved ART outcomes.
Collapse
Affiliation(s)
- Jessica N Schardein
- Department of Surgery, Division of Urology, University of Utah, Salt Lake City, Utah, USA
| | | | | |
Collapse
|
11
|
BUDAK Ö, BOSTANCI MS, KÖSE O, AKDEMİR N, GÖKÇE A, CEVRİOĞLU S. Evaluation Of The Clinical Results Of Using Microfluidic Channel System For Sperm Selection In IVF Cycles In Patients With Low Sperm Concentration. KONURALP TIP DERGISI 2022. [DOI: 10.18521/ktd.1171576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objective: Microfluidic channel system (MAC), a new generation method, gives the chance to select better quality spermatozoa with lower DNA fragmentation indices. This study evaluated the treatment results in patients who underwent ICSI-ET due to the MAC technique's male factors.
Methods: Sakarya University ART Center carried out this retrospective study. Patients with 35 male factor indications were included in our study. In these patients, swim-up (SU) was used in the first of two consecutive IVF cycles, and the MAC sperm preparation technique was used in the second. Our study compared fertilization, quality embryo counts, implantation after fresh embryo transfer, pregnancy rates, fifth-day embryo, and frozen embryo numbers.
Results: Fertilization rate was higher in the MAC group than in the SU group (P=0.009). The number of 3rd and 5th Day Grade 1 embryo in the MAC group was statistically higher than in the SU group (p=0.000 for both parameters). The number of quality embryos frozen on day 5 was higher in the MAC group than in the SU group (P=0.000).
Conclusions: It is thought that MAC application does not make a statistically significant contribution on implantation and pregnancy in IVF cycles performed due to the malefactor. However, it may positively affect fertilization rate and embryo quality. In addition, we think that it increases the number of embryos frozen at the end of the cycle, and for this reason, the MAC technique may provide positive benefits to IVF treatments.
Collapse
Affiliation(s)
| | - Mehmet Sühha BOSTANCI
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| | - Osman KÖSE
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI
| | - Nermin AKDEMİR
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| | - Ahmet GÖKÇE
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| | - Serhan CEVRİOĞLU
- SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, KADIN HASTALIKLARI VE DOĞUM ANABİLİM DALI
| |
Collapse
|
12
|
Vega-Hidalgo J, Rodriguez M, Dipaz-Berrocal D, Rivas J, Huayhua C, Mellisho E. Sperm selection techniques in cattle: Microfilter device versus conventional methods. Andrologia 2022; 54:e14585. [PMID: 36098672 DOI: 10.1111/and.14585] [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: 03/20/2022] [Revised: 08/18/2022] [Accepted: 08/26/2022] [Indexed: 11/27/2022] Open
Abstract
Microfluidics and microfilter devices have been developed to mimic the characteristics of the female reproductive tract, minimizing the risk of sperm damage. This study aimed to compare the use of a microfilter device versus conventional methods for sperm selection used in in vitro fertilization (IVF). For selecting spermatozoa, the pooled samples were processed in a microfilter device, swim-up and mini-Percoll gradient. Kinematic and morphometric parameters, vitality and DNA damage were analysed before and after sperm selection. After selection, 10,000 motile spermatozoa per oocyte were used in IVF drops. Embryos were assessed at three (cleavage rate) and seven (blastocyst rate) days post-IVF. Results of sperm kinematic parameters including average path velocity, velocity straight line, curvilinear velocity, linearity, lateral head displacement with the microfilter device were superior to density gradient (p < 0.05), but similar to swim-up method. Likewise, sperm DNA damage was significantly reduced using the microfilter device and swim-up method. Regarding the total sperm recovery rate post selection, results with the microfilter device (17.64%) and mini-Percoll gradient (18.27%) were higher than with swim-up method (6.52%). However, the cleavage and blastocyst rates were the lowest using the microfilter device. In conclusion, sperm selection using the microfilter device and swim-up method can improve kinematic parameters, although the mini Percoll gradient was the most efficient method for embryo production.
Collapse
Affiliation(s)
- Jhorjhi Vega-Hidalgo
- Centro de Investigación en Tecnología de Embriones (CIETE), Programa de Mejoramiento Animal, Universidad Nacional Agraria La Molina, Lima, Peru
| | - Misael Rodriguez
- Centro de Investigación en Tecnología de Embriones (CIETE), Programa de Mejoramiento Animal, Universidad Nacional Agraria La Molina, Lima, Peru
| | - Deysi Dipaz-Berrocal
- Centro de Investigación en Tecnología de Embriones (CIETE), Programa de Mejoramiento Animal, Universidad Nacional Agraria La Molina, Lima, Peru
| | - Josselin Rivas
- Centro de Investigación en Tecnología de Embriones (CIETE), Programa de Mejoramiento Animal, Universidad Nacional Agraria La Molina, Lima, Peru
| | - Carmen Huayhua
- Centro de Investigación en Tecnología de Embriones (CIETE), Programa de Mejoramiento Animal, Universidad Nacional Agraria La Molina, Lima, Peru
| | - Edwin Mellisho
- Centro de Investigación en Tecnología de Embriones (CIETE), Programa de Mejoramiento Animal, Universidad Nacional Agraria La Molina, Lima, Peru
| |
Collapse
|
13
|
Luo Y, Liu M, Wu S, Zhang M, Yuan J, Zhong Y, Li Q, Sun X, Xu X, Zhu D. A comprehensive evaluation of pre- and post-processing sperm parameters for predicting successful pregnancy rate following intrauterine insemination with the husband's sperms. BMC Pregnancy Childbirth 2022; 22:703. [PMID: 36096780 PMCID: PMC9469606 DOI: 10.1186/s12884-022-05029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 08/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine the predictive values of sperm parameters pre- and post-processing by density gradient centrifugation for clinical pregnancy rates (CPRs) following artificial insemination by husband (AIH) in infertile Chinese couples. METHODS A total of 3,522 AIH cycles from 1,918 couples were retrospectively analyzed. The parameters were compared between the pregnant and non-pregnant groups and further between different etiological groups (Male-factor, Both-male-and-female-factor, and Other-factor). Multivariate logistic regression analysis was performed to create models for predicting the CPRs of each etiological group. RESULTS The overall CPR was 13.3%. There were significant improvements for most sperm parameters after DGC. Multivariate logistic regression analysis indicated that, in overall AIH cases, the top parameters significantly influencing the CPR of AIH were pre-STR (OR = 1.037; P = 0.048) and post-VSL (OR = 1.036; P = 0.011). In the Male-factor Group, the top influencing parameters were pre-VCL (OR = 2.096; P = 0.008), pre-LIN (OR = 1.930; P = 0.002) and post-VSL (OR = 1.316; P = 0.023). In the Both-factor Group, the top influencing parameters were pre-VCL (OR = 1.451; P = 0.008) and post-motility (OR = 1.218; P = 0.049). In the Other-factor Group, the top influencing parameters were pre-VAP (OR = 1.715; P = 0.024), pre-STR (OR = 1.20; P = 0.011) and post-VSL (OR = 1.04; P = 0.017). Moreover, receiver operating characteristic analysis showed that the logistic regression models of the Male- and Both-factor Groups had greater powers for prognostic classification than those of other groups. CONCLUSIONS This study demonstrated that some sperm parameters have a collinearity relationship in predicting the CPR following AIH. Moreover, the predictive capacity of a multivariate logistic regression model is better than those of individual parameters, especially for the Male- and Both-factor Groups. In these cases, pre-VCL is the common top influencing factor.
Collapse
Affiliation(s)
- Yumei Luo
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510182, China
| | - Mingxing Liu
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Shunhong Wu
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510182, China
| | - Mimi Zhang
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Jingru Yuan
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Yufang Zhong
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510182, China
| | - Qing Li
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Xiaofang Sun
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China.,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Xia Xu
- Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510182, China.
| | - Detu Zhu
- Department of Obstetrics and Gynecology, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China. .,Guangzhou Key Laboratory for Clinical Rapid Diagnosis and Early Warning of Infectious Diseases, Kingmed School of Laboratory Medicine, Guangzhou Medical University, Guangzhou, 510182, China.
| |
Collapse
|
14
|
Jia F, Wang S, Xu S, Wu W, Zhou L, Zeng J. The role of titanium surface micromorphology in MG-63 cell motility during osteogenesis. Sci Rep 2022; 12:9971. [PMID: 35705640 PMCID: PMC9200830 DOI: 10.1038/s41598-022-13854-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/30/2022] [Indexed: 11/09/2022] Open
Abstract
Different surface micromorphologies influence osteoblast movements and impact the osteogenesis around implants. In this study, a biomimetic chip that simulates the microenvironment of the implant and bone in vitro was developed (tissue-on-chip of group T and group C) to study the correlation of cell movement velocity (CMV), direction (CMD), acceleration (CMA), and cell attachment number (CA) with the surface micromorphology of the Titanium material. Computational fluid dynamics (CFD) was used for flow analysis. Changes in intraosseous pressure (IOP), local blood perfusion index (LBPI), new bone microstructure, microvessel density (MVD), and bone-implant contact (BIC) in beagle dogs were detected as implant surface alterations. Surface skewness (Ssk) and surface arithmetic mean height (Sa) were the most important negative factors for high CMV, accounting for 51% and 32%, respectively, of all the influencing factors. Higher Ssk (SskT > 0, SskC < 0) and Sa (SaT > SaC) resulted in lower CMV (CMVT:CMVC = 0.41:1), greater CA (CAT:CAC = 1.44:1), and higher BIC (BICT:BICC = 3.06:1) (P < 0.05). The surface micromorphology influenced the CMD of MG-63 cells within 20 μm from the material surface. However, it could not regulate the IOP, LBPI, MVD, new bone microstructure, or CMD (P > 0.05).
Collapse
Affiliation(s)
- Fang Jia
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China.
| | - Shuxiu Wang
- State Key Laboratory of Pulp and Paper Engineering, Plant Fiber Research Center, South China University of Technology, Guangzhou, 510640, China.,Guangdong Plant Fiber High-Valued Cleaning Utilization Engineering Technology Research Center, South China University of Technology, Guangzhou, 510640, China
| | - Shulan Xu
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Wangxi Wu
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Lei Zhou
- Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Jingsong Zeng
- State Key Laboratory of Pulp and Paper Engineering, Plant Fiber Research Center, South China University of Technology, Guangzhou, 510640, China. .,Guangdong Plant Fiber High-Valued Cleaning Utilization Engineering Technology Research Center, South China University of Technology, Guangzhou, 510640, China.
| |
Collapse
|
15
|
Loloi J, Petrella F, Kresch E, Ibrahim E, Zini A, Ramasamy R. The Effect of Sperm DNA Fragmentation on Male Fertility and Strategies for Improvement: A Narrative Review. Urology 2022; 168:3-9. [PMID: 35705123 DOI: 10.1016/j.urology.2022.05.036] [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: 02/19/2022] [Revised: 05/22/2022] [Accepted: 05/31/2022] [Indexed: 11/17/2022]
Abstract
The inability to conceive due to male infertility is a complex issue with a wide variety of etiologies. Sperm DNA damage can be both a barrier to natural pregnancy and successful assisted reproductive technology (ART). The aim of this narrative review was to describe and highlight the effects of sperm DNA fragmentation and the most recent data on various treatment strategies to decrease sperm DNA damage. Finally, we proposed a management algorithm for couples undergoing ART with increased sperm DNA fragmentation.
Collapse
Affiliation(s)
- Justin Loloi
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | | | - Eliyahu Kresch
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Emad Ibrahim
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL
| | - Armand Zini
- Department of Urology, McGill University, Montreal, Canada
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL.
| |
Collapse
|
16
|
Abstract
Sperm selection in the female reproductive tract (FRT) is sophisticated. Only about 1,000 sperm out of millions in an ejaculate reach the fallopian tube and thus have a chance of fertilizing an oocyte. In assisted reproduction techniques, sperm are usually selected using their density or motility, characteristics that do not reflect their fertilization competence and, therefore, might result in failure to fertilize the oocyte. Although sperm processing in in vitro fertilization (IVF) and intrauterine insemination (IUI) bypasses many of the selection processes in the FRT, selection by the cumulus mass and the zona pellucida remain intact. By contrast, the direct injection of a sperm into an oocyte in intracytoplasmic sperm injection (ICSI) bypasses all natural selection barriers and, therefore, increases the risk of transferring paternal defects such as fragmented DNA and genomic abnormalities in sperm to the resulting child. Research into surrogate markers of fertilization potential and into simulating the natural sperm selection processes has progressed. However, methods of sperm isolation - such as hyaluronic acid-based selection and microfluidic isolation based on sperm tactic responses - use only one or two parameters and are not comparable with the multistep sperm selection processes naturally occurring within the FRT. Fertilization-competent sperm require a panel of molecules, including zona pellucida-binding proteins and ion channel proteins, that enable them to progress through the FRT to achieve fertilization. The optimal artificial sperm selection method will, therefore, probably need to use a multiparameter tool that incorporates the molecular signature of sperm with high fertilization potential, and their responses to external cues, within a microfluidic system that can replicate the physiological processes of the FRT in vitro.
Collapse
|
17
|
Sperm Selection and Embryo Development: A Comparison of the Density Gradient Centrifugation and Microfluidic Chip Sperm Preparation Methods in Patients with Astheno-Teratozoospermia. Life (Basel) 2021; 11:life11090933. [PMID: 34575082 PMCID: PMC8466221 DOI: 10.3390/life11090933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/28/2022] Open
Abstract
In recent years, microfluidic chip-based sperm sorting has emerged as an alternative tool to centrifugation-based conventional techniques for in vitro fertilization. This prospective study aims to compare the effects of density gradient centrifugation and microfluidic chip sperm preparation methods on embryo development in patient populations with astheno-teratozoospermia. In the study, the semen samples of the patients were divided into two groups for preparation with either the microfluidic or density gradient methods. Selected spermatozoa were then used to fertilize mature sibling oocytes and the semen parameters and embryo development on days 3 and 5 were assessed. While the density gradient group was associated with a higher sperm concentration, motility (progressive and total) was significantly higher in the microfluidic chip group. No significant differences were observed in the fertilization rates or grade 1 (G1) and grade 2 (G2) proportions of the third-day embryos. Furthermore, while the proportions of the poor, fair and good blastocysts on day 5 did not differ significantly, excellent blastocysts (indicating high-quality embryos) were observed in a significantly higher proportion of the microfluidic chip group. When compared to the classical density gradient method, the microfluidic chip sperm preparation yielded sperm with higher motility and higher quality blastocysts at day 5; in patients with astheno-teratozoospermia.
Collapse
|
18
|
Simchi M, Riordon J, You JB, Wang Y, Xiao S, Lagunov A, Hannam T, Jarvi K, Nosrati R, Sinton D. Selection of high-quality sperm with thousands of parallel channels. LAB ON A CHIP 2021; 21:2464-2475. [PMID: 33982043 DOI: 10.1039/d0lc01182g] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Sperm selection is essential for successful fertilization and embryo development. Current clinical sperm selection methods are labor-intensive and lack the selectivity required to isolate high-quality sperm. Microfluidic sperm selection approaches have shown promise but present a trade-off between the quality and quantity of selected sperm - clinicians demand both. The structure of the female reproductive tract helps to isolate a sufficient quantity of high-quality sperm for fertilization with densely folded epithelium that provides a multitude of longitudinally oriented pathways that guide sperm toward the fertilization site. Here, a three-dimensionally structured sperm selection device is presented that levers this highly parallelized in vivo mechanism for in vitro sperm selection. The device is inserted in a test tube atop 1 mL of raw semen and provides 6500 channels that isolate ∼100 000 high-DNA-integrity sperm for assisted reproduction. In side-by-side clinical testing, the developed approach outperforms the best current clinical methods by improving the DNA integrity of the selected sperm subpopulation up to 95%. Also, the device streamlines clinical workflow, reducing the time required for sperm preparation 3-fold. This single-tube, single-step sperm preparation approach promises to improve both the economics and outcomes of assisted reproduction practices, especially in cases with significant male-factors.
Collapse
Affiliation(s)
- Mohammad Simchi
- Department of Mechanical and Industrial Engineering, University of Toronto, 5 King's College Road, Toronto, Ontario M5S 3G8, Canada.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Barda S, Mano R, Lehavi O, Kleiman SE, Yossepowitch O, Azem F, Hauser R, Dekalo S. Questioning the utility of round spermatid injections in men with non-obstructive azoospermia. Andrology 2021; 9:1145-1150. [PMID: 33774922 DOI: 10.1111/andr.13008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Data on who among the infertile male population may benefit from round spermatid injections (ROSI) are lacking. OBJECTIVE To determine the probability of finding round spermatids suitable for ROSI in men with non-obstructive azoospermia (NOA) in whom no spermatozoa were retrieved at testicular sperm extraction. MATERIALS AND METHODS Four-hundred fifty-seven consecutive men with azoospermia underwent testicular sperm extraction. Clinical examination included age, secondary sexual characteristics, testicular size, reproductive hormone estimation, karyotyping, and Y chromosome microdeletion analyses. Histologic examination was performed, and histologic classification was determined by the most advanced spermatogenetic cell identified in the combined histologic and cytologic examination. RESULTS Of the 457 azoospermic men, 342 were diagnosed with NOA, and 148 (148/342, 43%) had mixed atrophy on histopathology and retrievable spermatozoa. No spermatozoa were found in 194/342 men with NOA (57%). Histopathology diagnosed 145/194 (75%) of them with Sertoli cell only, 45/194 (23%) with spermatocyte maturation arrest, and 4/194 (2%) with spermatid maturation arrest. CONCLUSIONS Histopathologically identified round spermatids without spermatozoa were rare in men with NOA. Only very few of them are likely to reap the benefits of ROSI, thus presenting the need to reconsider its actual clinical value.
Collapse
Affiliation(s)
- Shimi Barda
- Institute for the Study of Fertility, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Israel Academic College, Ramat Gan, Israel
| | - Roy Mano
- Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Lehavi
- Institute for the Study of Fertility, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sandra E Kleiman
- Institute for the Study of Fertility, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofer Yossepowitch
- Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Foad Azem
- Racine IVF Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Hauser
- Institute for the Study of Fertility, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Snir Dekalo
- Institute for the Study of Fertility, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
20
|
Anbari F, Khalili MA, Sultan Ahamed AM, Mangoli E, Nabi A, Dehghanpour F, Sabour M. Microfluidic sperm selection yields higher sperm quality compared to conventional method in ICSI program: A pilot study. Syst Biol Reprod Med 2021; 67:137-143. [PMID: 33451252 DOI: 10.1080/19396368.2020.1837994] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
An appropriate preparation technique, should be capable of isolating highquality spermatozoa for intracytoplasmic sperm injection (ICSI). The aim was to assess sperm quality parameters, DNA integrity, embryo development, and clinical outcomes using a practical and accessible Microfluidic Sperm Sorting (MSS) technique. A total of 95 ICSI cases performed using sperm samples were prepared with our MSS (group 1) or by Direct Swim Up (DSU; control) method (group 2). Both sperm quality parameters and sperm DNA fragmentation (SDF) were compared between the groups. DNA fragmentation was assessed using Sperm Chromatin Dispersion (SCD) test and fine morphology was assessed using Motile Sperm Organelle Morphology Examination (MSOME). Embryo development and clinical outcomes were compared between the groups. In the MSS group, progressive motility and the fraction of Class I sperm morphology sperm were significantly higher compared to DSU group (P < 0.01 and P < 0.001, respectively). Moreover, the rates of DNA fragmentation and immotile spermatozoa were significantly lower in MSS when compared to DSU group (P < 0.001). Also, higher rates of high-quality embryo formation (P < 0.001), implantation (P = 0.04) and pregnancy (P = 0.05) were achieved in the MSS compared to DSU groups. The MSS technique proved to be a noninvasive, disposable, easy to use, and inexpensive method for separation of high-quality spermatozoa. Both laboratory parameters and clinical outcomes were improved with application of MSS for neat sperm collection in ICSI.AbbreviationsICSI: Intracytoplasmic Sperm Injection; MSS: Microfluidic Sperm Sorting; Sperm DNA Fragmentation (SDF); SCD: Sperm Chromatin Dispersion; MSOME: Motile Sperm Organelle Morphology Examination; DGC: Density Gradient Centrifugation; DSU: Direct Swim Up; ROS: Reactive Oxygen Species; ART: Assisted Reproducetive Technology.
Collapse
Affiliation(s)
- Fatemeh Anbari
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Ali Khalili
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Esmat Mangoli
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Nabi
- Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Andrology Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fatemeh Dehghanpour
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojdeh Sabour
- Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
21
|
Jellerette-Nolan T, Cooper AR, Doody KJ, Nichols JE, Park JK, Poe-Zeigler RL, Khair AF, Stong LM, Paulson RJ, Daftary GS. Real-world experience with intravaginal culture using INVOCELL: an alternative model for infertility treatment. F S Rep 2020; 2:9-15. [PMID: 34223267 PMCID: PMC8244350 DOI: 10.1016/j.xfre.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/05/2020] [Accepted: 11/13/2020] [Indexed: 11/29/2022] Open
Abstract
Objective To describe the current practice indications, methodology, and outcomes from a real-world experience of intravaginal culture (IVC) using INVOCELL. Design A descriptive study outlining real-world experience with INVOCELL that addresses patient selection, ovarian stimulation, embryology laboratory practices, and outcomes. Setting Five fertility centers in Missouri, Texas, North Carolina, South Carolina, and Virginia. Patients Four hundred sixty-three patients undergoing 526 cycles. Intervention IVC using INVOCELL. Main Outcome Measures Cumulative pregnancy rate and live births. Secondary outcomes of interest included percent good quality embryos. Results IVC with INVOCELL was primarily used in women <38 years with anti-Mullerian hormone level >0.8 ng/mL. The mean numbers of retrieved oocytes ranged from 9.2 to 16. Mean numbers of oocytes and sperm-injected oocytes loaded per INVOCELL ranged from a mean of 6.4–9.5 with a reported maximum of 34 oocytes loaded into the device. Most (95%) of the embryos were transferred on day 5. The mean blastocyst recovery per oocyte loaded into the device ranged from 19% to 34%; mean cumulative live birth plus ongoing pregnancy rates ranged from 29% to 53% per cycle start and 40% to 61% per transfer. Conclusions This study of IVC using INVOCELL as an alternative model for infertility treatment confirms its utility as a viable alternative to standard incubator-based in vitro fertilization. The technology is compatible within the current framework of practice patterns and, when appropriately used, results in acceptable blastocyst recovery and live birth rates. Further use of INVOCELL in other clinical situations is warranted.
Collapse
Affiliation(s)
| | | | | | - John E Nichols
- Piedmont Reproductive Endocrinology Group, Greenville, South Carolina
| | - John K Park
- Carolina Conceptions, Raleigh, North Carolina
| | | | | | - Laura M Stong
- Ferring Pharmaceuticals Inc., Parsippany, New Jersey
| | - Richard J Paulson
- Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, California
| | | |
Collapse
|
22
|
Patel DP, Jenkins TG, Hotaling JM. Microfluidics: a way to interrogate a single sperm? Fertil Steril 2020; 112:808. [PMID: 31731937 DOI: 10.1016/j.fertnstert.2019.08.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Darshan P Patel
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah
| | - Tim G Jenkins
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, Utah
| |
Collapse
|
23
|
Akerman JP, Hayon S, Coward RM. Sperm Extraction in Obstructive Azoospermia: What's Next? Urol Clin North Am 2020; 47:147-155. [PMID: 32272986 DOI: 10.1016/j.ucl.2019.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
For men with obstructive azoospermia, several surgical sperm retrieval techniques can facilitate conception with assisted reproductive technology. The evolution of both percutaneous and open approaches to sperm retrieval has been affected by technological innovations, including the surgical microscope, in vitro fertilization, and intracytoplasmic sperm injection. Further modifications to these procedures are designed to minimize patient morbidity and increase the quality and quantity of sperm samples. Innovative technologies promise to further ameliorate outcomes by selecting the highest quality sperm. Although various approaches to surgical sperm retrieval are now well established, several advancements in sperm selection and optimization are being developed.
Collapse
Affiliation(s)
- Jason P Akerman
- Department of Urology, University of North Carolina, 2113 Physician's Office Building, CB#7235, Chapel Hill, NC 27599-7235, USA.
| | - Solomon Hayon
- Department of Urology, University of North Carolina, 2113 Physician's Office Building, CB#7235, Chapel Hill, NC 27599-7235, USA
| | - Robert Matthew Coward
- Department of Urology, University of North Carolina, 2113 Physician's Office Building, CB#7235, Chapel Hill, NC 27599-7235, USA; UNC Fertility, 7920 ACC Blvd #300, Raleigh, North Carolina 27617, USA
| |
Collapse
|