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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.
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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
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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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Salehi Novin M, Mehdizadeh A, Artimani T, Bakhtiari M, Mehdizadeh M, Aflatoonian R, Zandieh Z. MACS-DGC sperm preparation method resulted in high-quality sperm, top-quality embryo, and higher blastocyst rate in male factor infertile couples with high DNA fragmented sperm. HUM FERTIL 2023; 26:1408-1416. [PMID: 37469268 DOI: 10.1080/14647273.2023.2236297] [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: 07/20/2022] [Accepted: 06/15/2023] [Indexed: 07/21/2023]
Abstract
Conventional sperm selection based on motility and morphology fails to provide detailed information on sperm functional and molecular status. Magnetic-activated cell sorting (MACS) protocol aims to optimize this process by selecting apoptotic sperm cells. Phospholipase C zeta-1 (PLCz1) is a physiological stimulus for oocyte activation and early embryonic development. The purpose of this study was to examine seminal parameters, DNA fragmentation index (DFI), and PLCz1 expression levels in MACS-DGC sorted specimens (DFI > 30%) and assess early development in resulting embryos. Semen specimens from 60 patients diagnosed with male factor infertility were collected and processed by either density gradient centrifugation (DGC) or MACS-DGC protocols. Pre and post-preparation analysis was performed. PLCz1 expression was assessed using the RT-PCR method. Retrieved eggs from their partners were divided into two groups in which they were injected with different sorted sperm. The fertilization rate and embryonic development were evaluated. While sperm's progressive motility and morphology significantly improved, there was a substantial decline in DFI following MACS-DGC. Fertilization rates were almost the same between the groups, and the latter resulted in remarkably more top-quality embryos and more blastocysts. PLCz1 expression was considerably higher in the MACS-DGC group. By eliminating apoptotic cells, the MACS-DGC technique could sort highly PLCz1-expressed sperm, optimize sperm selection in individuals with elevated DFI, development of resulting embryos.
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Affiliation(s)
| | | | - Tayebe Artimani
- Endometrium & Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mehrdad Bakhtiari
- Department of Anatomy, Iran University of Medical Science, Tehran, Iran
| | - Mehdi Mehdizadeh
- Reproductive Sciences and Technology Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Aflatoonian
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Centre, Royan Institute for Reproductive Biomedicine, Tehran, Iran
| | - Zahra Zandieh
- Reproductive Sciences and Technology Research Center, Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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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.
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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
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Assumpção TI, Lançoni R, Foschini M, Vieira CS. Equine Spermatozoa Selection by Magnetic Activation for Use in Assisted Reproduction. J Equine Vet Sci 2023; 123:104245. [PMID: 36773851 DOI: 10.1016/j.jevs.2023.104245] [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: 12/12/2022] [Revised: 01/30/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
This study aimed to select high-quality spermatozoa by sperm separation by magnetic activation of the fresh equine semen, compared to density gradient centrifugation and evaluating cell quality after selection. The semen of 10 stallions was collected by the artificial vagina technique. The samples analyzed were: (1) fresh semen; (2) density gradient centrifugation (DGC); (3) separation by magnetic activation (MASS) (nonapoptotic portion NAP); (4) separation by MASS (apoptotic portion-APT). Was analyzed: motility (light microscopy), concentration (Neubauer chamber), semen morphology (humid chamber in phase contrast), and supravital test (eosin/nigrosine). In DGC, 20 × 106 spermatozoa were used in the gradient of Percoll at 90% and 45% (400 μL each), centrifugation at 900 G/5 min, the pellet was diluted in HEPES. In MASS, 10 × 106 spermatozoa were diluted in 1.5 mL of HEPES, centrifugation at 300 G/10 min, pellet was resuspended in 150 μL of HEPES with 20 μL of nanoparticles bound to annexin V, incubation for 15 minutes and filtered in the magnetic separation column. The nonapoptotic fraction was collected directly and the apoptotic fraction after removal the column from the magnet and adding 300 μL of HEPES. The total abnormalities were 43.2% ± 2.78%, with the DGC and MASS being effective in reducing sperm abnormality by 15.6% ± 2.10% and 24.30% ± 1.63%, respectively, like the observed for the number of cells with intact membranes (50% lower in the APT portion). This nanotechnological method is efficient in producing high-quality semen samples for assisted reproduction procedures.
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Affiliation(s)
- Teresinha Inês Assumpção
- Faculty of Veterinary Medicine and Animal Science, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
| | - Renata Lançoni
- Faculty of Veterinary Medicine and Animal Science, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Mauricio Foschini
- Physics Institute, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
| | - Caroline Silva Vieira
- Faculty of Veterinary Medicine and Animal Science, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil
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Vasilescu SA, Ding L, Parast FY, Nosrati R, Warkiani ME. Sperm quality metrics were improved by a biomimetic microfluidic selection platform compared to swim-up methods. MICROSYSTEMS & NANOENGINEERING 2023; 9:37. [PMID: 37007605 PMCID: PMC10050147 DOI: 10.1038/s41378-023-00501-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/02/2022] [Accepted: 01/20/2023] [Indexed: 06/19/2023]
Abstract
Sperm selection is an essential component of all assisted reproductive treatments (ARTs) and is by far the most neglected step in the ART workflow in regard to technological innovation. Conventional sperm selection methodologies typically produce a higher total number of sperm with variable motilities, morphologies, and levels of DNA integrity. Gold-standard techniques, including density gradient centrifugation (DGC) and swim-up (SU), have been shown to induce DNA fragmentation through introducing reactive oxygen species (ROS) during centrifugation. Here, we demonstrate a 3D printed, biologically inspired microfluidic sperm selection device (MSSP) that utilizes multiple methods to simulate a sperms journey toward selection. Sperm are first selected based on their motility and boundary-following behavior and then on their expression of apoptotic markers, yielding over 68% more motile sperm than that of previously reported methods with a lower incidence of DNA fragmentation and apoptosis. Sperm from the MSSP also demonstrated higher motile sperm recovery after cryopreservation than that of SU or neat semen. Experiments were conducted side-by-side against conventional SU methods using human semen (n = 33) and showed over an 85% improvement in DNA integrity with an average 90% reduction in sperm apoptosis. These results that the platform is easy-to-use for sperm selection and mimics the biological function of the female reproductive tract during conception.
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Affiliation(s)
| | - Lin Ding
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW 2007 Australia
| | - Farin Yazdan Parast
- Department of Mechanical & Aerospace Engineering, Monash University, Clayton, VIC 3800 Australia
| | - Reza Nosrati
- Department of Mechanical & Aerospace Engineering, Monash University, Clayton, VIC 3800 Australia
| | - Majid Ebrahimi Warkiani
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW 2007 Australia
- Institute for Biomedical Materials & Devices (IBMD), Faculty of Science, University of Technology Sydney, Sydney, NSW 2007 Australia
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Zhao C, Sun L, Zhao P. Effects of sperm processing techniques on IVF pregnancy rates: a mini-review. Ther Adv Reprod Health 2023; 17:26334941231188656. [PMID: 37497119 PMCID: PMC10366343 DOI: 10.1177/26334941231188656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023] Open
Abstract
Many factors associated with assisted reproductive technologies significantly influence the success of pregnancy after in vitro fertilization (IVF) either directly or indirectly. These factors include sperm processing techniques, egg retrieval, intrauterine artificial insemination, intracytoplasmic sperm injection, and embryo transfer. Among these technologies, sperm quality is one of the most critical factors for a successful IVF pregnancy. The method used for sperm processing plays a crucial role in determining the quality of sperm. Several widely used sorting techniques, such as conventional swim-up, density gradient centrifugation, magnetic activated cell sorting, and hyaluronic acid, have been extensively compared in various studies. Previous studies have shown that each sperm processing method causes varying degrees of sperm damage, particularly in sperm motility, concentration, morphological features, viability, and DNA integrity. However, sperm processing techniques have been developed slowly, and the impact of these methods on pregnancy rates is still unclear. Further exploration is needed. In this review, we aim to compare the results of different sperm processing techniques concerning sperm quality and IVF pregnancy rates. We will also discuss possible clinical approaches, such as microfluidics and integrated approaches, for testing and improving sperm quality.
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Affiliation(s)
- Cong Zhao
- Department of Prevention, Health Care and Fertility, Xinfuli Community Hospital, Beijing, China
| | - Lanming Sun
- Department of Prevention, Health Care and Fertility, Xinfuli Community Hospital, Beijing, China
| | - Pin Zhao
- Department of Clinical Laboratory, The Third People’s Hospital of Shenzhen, Southern University of Science and Technology, National Clinical Research Center for Infectious Diseases, 29th Bulan Road, Longgang District, Shenzhen, 518112, China
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González-Ravina C, Santamaría-López E, Pacheco A, Ramos J, Carranza F, Murria L, Ortiz-Vallecillo A, Fernández-Sánchez M. Effect of Sperm Selection by Magnetic-Activated Cell Sorting in D-IUI: A Randomized Control Trial. Cells 2022; 11:cells11111794. [PMID: 35681488 PMCID: PMC9180176 DOI: 10.3390/cells11111794] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/20/2022] [Accepted: 05/27/2022] [Indexed: 02/05/2023] Open
Abstract
Clinical outcome in assisted reproduction techniques (ARTs) is mainly influenced by the quality of gametes used. It is known that a high percentage of sperm DNA fragmentation (DNAf) decreases the success of ART clinical results. Therefore, techniques such as magnetic-activated cell sorting (MACS) help to improve results in cases of patients with a high percentage of DNAf. Cryopreservation of sperm in donor intrauterine insemination (D-IUI) treatments increases sperm DNAf, so patients using these sperm samples can benefit from using this technique. This prospective randomized national multicenter study analyzed clinical outcomes of 181 D-IUI treatments. MACS was performed after density gradient centrifugation (DGC) in 90 thawed semen donor samples (MACSG), whereas only DGC was performed in 91 thawed semen donor samples (CG). To our knowledge, this is the first study analyzing the effect of MACS on D-IUI cycles. Our results show no significant differences in gestation, live birth, or miscarriage rates between the two groups. We believe that further studies with a larger sample size are needed to evaluate the application of MACS in combination with standard IUI donor sperm preparations in fertility clinics.
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Affiliation(s)
- Cristina González-Ravina
- IVI-RMA Seville, Avda. Américo Vespucio 19, 41092 Seville, Spain; (C.G.-R.); (J.R.); (F.C.); (M.F.-S.)
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (L.M.); (A.O.-V.)
- Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, 41013 Seville, Spain
| | - Esther Santamaría-López
- IVI-RMA Seville, Avda. Américo Vespucio 19, 41092 Seville, Spain; (C.G.-R.); (J.R.); (F.C.); (M.F.-S.)
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (L.M.); (A.O.-V.)
- Correspondence: ; Tel.: +34-954-286-274
| | - Alberto Pacheco
- IVI-RMA Madrid, Avenida del Talgo 68, 28023 Madrid, Spain;
- Facultad Ciencias de la Salud, Universidad Alfonso X “El Sabio”, Villanueva de la Cañada, 28016 Madrid, Spain
| | - Julia Ramos
- IVI-RMA Seville, Avda. Américo Vespucio 19, 41092 Seville, Spain; (C.G.-R.); (J.R.); (F.C.); (M.F.-S.)
| | - Francisco Carranza
- IVI-RMA Seville, Avda. Américo Vespucio 19, 41092 Seville, Spain; (C.G.-R.); (J.R.); (F.C.); (M.F.-S.)
| | - Lucía Murria
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (L.M.); (A.O.-V.)
| | - Ana Ortiz-Vallecillo
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (L.M.); (A.O.-V.)
| | - Manuel Fernández-Sánchez
- IVI-RMA Seville, Avda. Américo Vespucio 19, 41092 Seville, Spain; (C.G.-R.); (J.R.); (F.C.); (M.F.-S.)
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (L.M.); (A.O.-V.)
- Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, 41013 Seville, Spain
- Departamento de Cirugía, Universidad de Sevilla, Avda. Sánchez Pizjuan S/N, 41009 Seville, Spain
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Gil Juliá M, Hervás I, Navarro-Gomezlechon A, Quintana F, Amorós D, Pacheco A, González-Ravina C, Rivera-Egea R, Garrido N. Cumulative live birth rates in donor oocyte ICSI cycles are not improved by magnetic-activated cell sorting sperm selection. Reprod Biomed Online 2022; 44:677-684. [PMID: 35184950 DOI: 10.1016/j.rbmo.2021.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/25/2021] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
RESEARCH QUESTION Does magnetic-activated cell sorting (MACS) for sperm selection increase cumulative live birth rates (CLBR) or improve clinical parameters of reproductive success in couples undergoing intracytoplasmic sperm injection (ICSI) with donor oocytes? DESIGN Retrospective multicentre observational study including data compiled from unselected couples who underwent ICSI cycles with donated oocytes in 15 Spanish IVIRMA fertility clinics (January 2008 to February 2020). Patients were divided into reference (standard semen processing, n = 40,157) and MACS (additional sperm selection step by MACS, n = 1,240) groups. CLBR were plotted on Kaplan-Meier curves and compared using the Mantel-Cox test. Proportions were compared with a generalized estimating equation model, and results were adjusted to clinically relevant variables. RESULTS The MACS group showed a 27.1% CLBR after one embryo was transferred and 81.6% after four; the reference group had CLBR of 19.6% and 78.5%, respectively. CLBR in the MACS group was 4.2% after five oocytes were used and 75.5% after 15; for the reference group, CLBR were 7.8% and 78.3%, respectively. Kaplan-Meier curves showed statistically significant differences in CLBR per number of embryos transferred and per number of donated metaphase II oocytes between the two groups (both P < 0.0001), but not for CLBR per embryo transfer. No significant differences between groups were found for classical clinical outcomes such as pregnancy and live birth rates per embryo transfer. CONCLUSIONS Although MACS sperm selection slightly increased the CLBR per embryo transferred compared with the reference group, this change was not clinically meaningful. MACS should not be recommended indiscriminately to all infertile patients undergoing ICSI with donated oocytes as a sperm processing add-on.
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Affiliation(s)
- María Gil Juliá
- IVI Foundation - IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Torre A, Planta 1ª, Valencia . 46026, Spain.
| | - Irene Hervás
- IVI Foundation - IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Torre A, Planta 1ª, Valencia . 46026, Spain
| | - Ana Navarro-Gomezlechon
- IVI Foundation - IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Torre A, Planta 1ª, Valencia . 46026, Spain
| | - Fernando Quintana
- IVIRMA Bilbao, Landabarri Bidea, 1-3, Planta 2ª, Leioa Bizkaia 48940, Spain
| | - David Amorós
- IVIRMA Barcelona, Ronda del General Mitre, 14, Barcelona 08017, Spain
| | | | | | | | - Nicolás Garrido
- IVI Foundation - IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Torre A, Planta 1ª, Valencia . 46026, Spain
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10
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Moradi M, Hajarian H, Karamishabankareh H, Soltani L, Soleymani B. Pre-treatment of ram semen extender with magnetic nanoparticles on freeze-thawed spermatozoa. Vet Med Sci 2021; 8:792-798. [PMID: 34914199 PMCID: PMC8959327 DOI: 10.1002/vms3.689] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Extensive use of different nanoparticles caused significant concerns about their biological safety. Objective This study aimed to evaluate the effects of cryopreservation on ram semen after adding magnetic nanoparticles (MNPs) to separate X and Y chromosome‐bearing spermatozoa. Methods The experimental ram sperms in this research included treated spermatozoa (50 μg/ml MNPs) and non‐treated spermatozoa. DNA damage of spermatozoa was examined using an acridine orange (AO) assay. Sperm viability, membrane functionality, abnormality and malondialdehyde (MDA) level were also measured. Results Results indicated that the pre‐treatment of ram semen extender with MNPs did not significantly affect the semen parameters such as viability, membrane functionality, abnormality, as well as lipid peroxidation (LPO) levels and DNA integrity in comparison with the control group (p < 0.05). Conclusions These observations suggest that pre‐treatment of ram semen extender with MNPs after semen sexing did not have adverse effects on different semen parameters after cryopreservation. In the current study, we evaluated the effects of cryopreservation on ram semen after adding magnetic nanoparticles (MNPs), then after thawing some semen parameters were evaluated.
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Affiliation(s)
- Maryam Moradi
- Faculty of Agricultural and Engineering Science, Department of Animal Science, Razi University, Kermanshah, Iran
| | - Hadi Hajarian
- Faculty of Agricultural and Engineering Science, Department of Animal Science, Razi University, Kermanshah, Iran
| | - Hamed Karamishabankareh
- Faculty of Agricultural and Engineering Science, Department of Animal Science, Razi University, Kermanshah, Iran
| | - Leila Soltani
- Faculty of Agricultural and Engineering Science, Department of Animal Science, Razi University, Kermanshah, Iran
| | - Bijan Soleymani
- Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Science, Kermanshah, Iran
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11
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Fraser B, Peters AE, Sutherland JM, Liang M, Rebourcet D, Nixon B, Aitken RJ. Biocompatible Nanomaterials as an Emerging Technology in Reproductive Health; a Focus on the Male. Front Physiol 2021; 12:753686. [PMID: 34858208 PMCID: PMC8632065 DOI: 10.3389/fphys.2021.753686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/06/2021] [Indexed: 12/24/2022] Open
Abstract
A growing body of research has confirmed that nanoparticle (NP) systems can enhance delivery of therapeutic and imaging agents as well as prevent potentially damaging systemic exposure to these agents by modifying the kinetics of their release. With a wide choice of NP materials possessing different properties and surface modification options with unique targeting agents, bespoke nanosystems have been developed for applications varying from cancer therapeutics and genetic modification to cell imaging. Although there remain many challenges for the clinical application of nanoparticles, including toxicity within the reproductive system, some of these may be overcome with the recent development of biodegradable nanoparticles that offer increased biocompatibility. In recognition of this potential, this review seeks to present recent NP research with a focus on the exciting possibilities posed by the application of biocompatible nanomaterials within the fields of male reproductive medicine, health, and research.
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Affiliation(s)
- Barbara Fraser
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, Australia.,Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Alexandra E Peters
- Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Reproductive Science, School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Jessie M Sutherland
- Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Reproductive Science, School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Mingtao Liang
- Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Reproductive Science, School of Biomedical Science and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - Diane Rebourcet
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, Australia.,Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Brett Nixon
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, Australia.,Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Robert J Aitken
- Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, Australia.,Pregnancy and Reproduction Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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12
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Magnetic-activated cell sorting improves high-quality spermatozoa in bovine semen. JOURNAL OF ANIMAL REPRODUCTION AND BIOTECHNOLOGY 2021. [DOI: 10.12750/jarb.36.2.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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13
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Gil Juliá M, Hervás I, Navarro-Gómez Lechón A, Quintana F, Amorós D, Pacheco A, González-Ravina C, Rivera-Egea R, Garrido N. Sperm Selection by Magnetic-Activated Cell Sorting before Microinjection of Autologous Oocytes Increases Cumulative Live Birth Rates with Limited Clinical Impact: A Retrospective Study in Unselected Males. BIOLOGY 2021; 10:biology10050430. [PMID: 34066115 PMCID: PMC8150702 DOI: 10.3390/biology10050430] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/23/2022]
Abstract
Simple Summary Many couples attending infertility clinics still need to repeat treatments and undergo several failed attempts before achieving a healthy newborn, which leaves room for improvement in the techniques we currently use in the clinic. Among the different procedures susceptible to improvement, the selection of the most adequate sperm to be injected inside the egg is crucial to the cycle’s success. Magnetic-activated cell sorting (MACS) is a technique that removes physiologically abnormal sperm that have started a programmed cell death (apoptotic) process from a semen sample. However, it is not recommended to all patients because there is no agreement between the published literature on whether it improves reproductive outcomes. This study used data from all intracytoplasmic sperm injection cycles performed using the patient’s own oocytes in our clinics from January 2008 to February 2020. Our findings support that MACS should not be recommended to all infertile couples, since there was no significant difference in results compared to treatments in which MACS was not used. This study provides clinicians and patients with more accurate information on how MACS will impact their chances of pregnancy, and it will lead to studies focused on specific populations to which the technique can be particularly helpful. Abstract The application of MACS non-apoptotic sperm selection in infertility clinics is controversial since the published literature does not agree on its effect on reproductive outcomes. Therefore, it is not part of the routine clinical practice. Classical measures of reproductive success (pregnancy or live birth rates per ovarian stimulation) introduce a bias in the evaluation of a technique’s effect, since only the best embryo is transferred. This retrospective, multicenter, observational study evaluated the impact of MACS on reproductive outcomes, measuring results in classical parameters and cumulative live birth rates (CLBR). Data from ICSI cycles using autologous oocyte in Spanish IVIRMA fertility clinics from January 2008 to February 2020 were divided into two groups according to their semen processing: standard practice (reference: 46,807 patients) versus an added MACS sperm selection (1779 patients). Only when measured as CLBR per embryo transferred and per MII oocyte used was the difference between groups statistically significant. There were no significant differences between MACS and reference groups on pregnancy and live birth rates. In conclusion, results suggest that non-apoptotic sperm selection by MACS on unselected males prior to ICSI with autologous oocytes has limited clinical impact, showing a subtle increase in CLBR per embryo transferred.
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Affiliation(s)
- María Gil Juliá
- Andrology and Male Infertility Research Group, IVI Foundation—IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain; (I.H.); (A.N.-G.L.); (N.G.)
- Correspondence:
| | - Irene Hervás
- Andrology and Male Infertility Research Group, IVI Foundation—IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain; (I.H.); (A.N.-G.L.); (N.G.)
| | - Ana Navarro-Gómez Lechón
- Andrology and Male Infertility Research Group, IVI Foundation—IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain; (I.H.); (A.N.-G.L.); (N.G.)
| | - Fernando Quintana
- IVIRMA Bilbao, Landabarri Bidea, 1–3, 2nd Floor, 48940 Leioa Bizkaia, Spain;
| | - David Amorós
- IVIRMA Barcelona, Ronda del General Mitre, 14, 08017 Barcelona, Spain;
| | | | | | | | - Nicolás Garrido
- Andrology and Male Infertility Research Group, IVI Foundation—IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain; (I.H.); (A.N.-G.L.); (N.G.)
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14
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Sicchieri F, Silva AB, Santana VP, Vasconcelos MAC, Ferriani RA, Vireque AA, Dos Reis RM. Phosphatidylcholine and L-acetyl-carnitine-based freezing medium can replace egg yolk and preserves human sperm function. Transl Androl Urol 2021; 10:397-407. [PMID: 33532327 PMCID: PMC7844480 DOI: 10.21037/tau-20-1004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Conventional cryopreservation methods induce chemical and mechanical damage to the sperm membranes. The cryoprotectant potential of phospholipids of vegetal origin as soybean lecithin has been investigated as a substitute for egg yolk in diluents used for the cryopreservation of human spermatozoa. Therefore, the objective of this study was comparing the efficacy of a synthetic cryoprotectant supplemented with L-α-phosphatidylcholine (PC) and L-acetyl-carnitine (ANTIOX-PC) and the standard egg-based TEST-yolk buffer (TYB) in preserving sperm motility and chromatin quality in cryopreserved semen samples. Methods Prospective experimental study in which semen samples from 63 men with normal sperm motility and 58 men with low sperm motility were included and analyzed both before and after cryopreservation using ANTIOX-PC or TYB freezing media. Sperm quality was evaluated by routine semen analysis and DNA fragmentation index using the Terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Results Differences in the post-thaw progressive motility and DNA fragmentation index were not detected between TYB and ANTIOX-PC cryoprotectants in both normal and low sperm motility groups (P>0.05). However, ANTIOX-PC medium retained higher non-progressive motility and lower percentage of immotile sperm when compared to TYB medium, resulting in a greater total motile sperm count (P<0.05), regardless baseline values of motility characteristic of the normospermic or asthenozoospermic samples. Conclusions ANTIOX-PC medium was effective to protect human sperm during a freeze-thaw cycle compared to the TYB medium. A clinically relevant advantage in better preserving kinetic parameters as higher total motility and lower immotile post-thawed sperm from ANTIOX-PC, in normal and low motility semen samples, demonstrated the positive impact of phospholipid and antioxidant treatment on sperm cryotolerance with high potential for egg yolk lipids replacement and biosafety.
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Affiliation(s)
- Fernanda Sicchieri
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Aline Bomfim Silva
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Viviane Paiva Santana
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,National Institutes of Hormones and Woman's Health, CNPq, Brazil
| | - Alessandra Aparecida Vireque
- Invitra - Assisted Reproductive Technologies Ltd., Supera Innovation and Technology Park, Ribeirão Preto, São Paulo, Brazil
| | - Rosana Maria Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,National Institutes of Hormones and Woman's Health, CNPq, Brazil
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15
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Pinto S, Carrageta DF, Alves MG, Rocha A, Agarwal A, Barros A, Oliveira PF. Sperm selection strategies and their impact on assisted reproductive technology outcomes. Andrologia 2020; 53:e13725. [PMID: 32596880 DOI: 10.1111/and.13725] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022] Open
Abstract
The application of assisted reproductive technologies (ART) has revolutionised the treatment of human infertility, giving hope to the patients previously considered incapable of establishing pregnancy. While semen analysis is performed to access whether a sample has an adequate number of viable, motile and morphologically normal sperm cells able to achieve fertilisation, sperm selection techniques for ART aim to isolate the most competent spermatozoon which is characterised by the highest fertilising potential. Based on the semen analysis results, the correct sperm selection technique must be chosen and applied. In this review, different sperm selection strategies for retrieving spermatozoa with the highest fertilising potential and their impact on ART outcomes are discussed. In addition, advantages and disadvantages of each method and the best suited techniques for each clinical scenario are described.
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Affiliation(s)
- Soraia Pinto
- Centre for Reproductive Genetics A. Barros, Porto, Portugal
| | - David F Carrageta
- Department of Microscopy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Marco G Alves
- Department of Microscopy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - António Rocha
- CECA/ICETA - Centro de Estudos de Ciência Animal, Universidade do Porto & Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Alberto Barros
- Centre for Reproductive Genetics A. Barros, Porto, Portugal.,Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Pedro F Oliveira
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, Aveiro, Portugal
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16
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Marzano G, Chiriacò MS, Primiceri E, Dell’Aquila ME, Ramalho-Santos J, Zara V, Ferramosca A, Maruccio G. Sperm selection in assisted reproduction: A review of established methods and cutting-edge possibilities. Biotechnol Adv 2020; 40:107498. [DOI: 10.1016/j.biotechadv.2019.107498] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 11/26/2019] [Accepted: 12/06/2019] [Indexed: 12/31/2022]
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17
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Ghorbani-Sini R, Izadi T, Tavalaee M, Azadi L, Hajian M, Rahimi Zamani M, Nasr-Esfahani MH. Comparison of Sperm Telomere Length between Two Sperm Selection Procedures: Density Gradient Centrifugation and Zeta Potential. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:51-56. [PMID: 32112636 PMCID: PMC7139234 DOI: 10.22074/ijfs.2020.5981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 07/01/2019] [Indexed: 11/04/2022]
Abstract
Background Telomeres are particular sequences of DNA located at the end of the eukaryotic chromosomes that are essential for genome integrity. Telomere length in spermatozoa differs among males, as well as spermatozoa. Also, decreased telomere length in spermatozoa of infertile men is associated with the reduction of fertility potential and embryo quality. Density gradient centrifugation (DGC) and swim-up are useful techniques for separation of spermatozoa with longer telomeres. Also, the selection of sperm based on surface negative electric charge or "Zeta potential", can separate high percentage of spermatozoa with intact chromatin compared to DGC alone, and also the combination of DGC-Zeta can improve clinical outcomes of infertile men candidate for intracytoplasmic sperm injection (ICSI). Therefore, we compared sperm telomere length and DNA fragmentation between two sperm preparation procedures, namely DGC and zeta potential. Materials and Methods In this experimental study, we assessed sperm telomere length and DNA fragmentation by quantitative real-time polymerase chain reaction (PCR) and TUNEL assay methods, respectively. The spermatozoa were obtained from infertile men with normozoospermia between September 2017 and December 2017 and prepared either by DGC or zeta potential methods. Sperm telomere length was expressed as relative and absolute units. Results Compared with washed semen samples or control, no significant (P>0.05) difference was observed in the mean relative or absolute sperm telomere length when the two methods DGC or zeta potential were compared. However, the mean percentage of DNA fragmentation was significantly (P<0.05) lower in spermatozoa prepared by DGC or zeta potential methods than spermatozoa obtained from control samples. Conclusion This is the first study that compared the effect of DGC and zeta potential as the sperm preparation methods on sperm telomere length. It seems that both methods can select sperm population with high DNA integrity and the same sperm telomeres length.
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Affiliation(s)
- Razieh Ghorbani-Sini
- ACECR Institute of Higher Education (Isfahan Branch), Isfahan, Iran.,Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Tayebeh Izadi
- Department of Cellular Biotechnology, Cell Science Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Marziyeh Tavalaee
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Leila Azadi
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mehdi Hajian
- Department of Reproduction and Development, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mahshid Rahimi Zamani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran. Electronic Address: .,Isfahan Fertility and Infertility Center, Isfahan, Iran
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18
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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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19
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Oseguera-López I, Ruiz-Díaz S, Ramos-Ibeas P, Pérez-Cerezales S. Novel Techniques of Sperm Selection for Improving IVF and ICSI Outcomes. Front Cell Dev Biol 2019; 7:298. [PMID: 31850340 PMCID: PMC6896825 DOI: 10.3389/fcell.2019.00298] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022] Open
Abstract
Almost 50% of the infertility cases are due to male factors. Assisted reproductive technologies (ARTs) allow to overcome the incapacity of these patients' spermatozoa to fertilize the oocyte and produce a viable and healthy offspring, but the efficiency of the different techniques has still the potential to improve. According to the latest reports of the European Society of Human Reproduction and Embryology (ESHRE) and the Centers for Disease Control and Prevention of the United States (CDC), the percentages of deliveries per ART cycle in 2014 and 2016 were 21 and 22%, respectively. Among the reasons for this relatively low efficiency, the quality of the spermatozoa has been pointed out as critical, and the presence of high percentages of DNA-damaged spermatozoa in patients' ejaculates is possibly one of the main factors reducing the ARTs outcomes. Thus, one of the main challenges in reproductive medicine is to ensure the highest quality of the spermatozoa used in ARTs, and specifically, in terms of genetic integrity. The latest techniques for the preparation and selection of human spermatozoa are herein discussed focusing on those proven to improve one or several of the following parameters: sperm genetic integrity, fertilization capacity, embryo production, and in vitro survival, as well as pregnancy and delivery rates following in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). In addition, we discuss the potential of techniques developed in non-human mammals that could be further transferred to the clinic.
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Affiliation(s)
| | - Sara Ruiz-Díaz
- Mistral Fertility Clinics S.L., Clínica Tambre, Madrid, Spain
- Department of Animal Reproduction, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
| | - Priscila Ramos-Ibeas
- Department of Animal Reproduction, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
| | - Serafín Pérez-Cerezales
- Department of Animal Reproduction, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
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20
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Boomsma CM, Cohlen BJ, Farquhar C. Semen preparation techniques for intrauterine insemination. Cochrane Database Syst Rev 2019; 10:CD004507. [PMID: 31612995 PMCID: PMC6792139 DOI: 10.1002/14651858.cd004507.pub4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Semen preparation techniques for assisted reproduction, including intrauterine insemination (IUI), were developed to select the motile morphologically normal spermatozoa. The yield of many motile, morphologically normal spermatozoa might influence treatment choices and therefore outcomes. OBJECTIVES To compare the effectiveness of three different semen preparation techniques (gradient; swim-up; wash and centrifugation) on clinical outcomes (live birth rate; clinical pregnancy rate) in subfertile couples undergoing IUI. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group (CGFG) trials register, CENTRAL, MEDLINE, Embase, Science Direct Database, National Research Register, Biological Abstracts and clinical trial registries in March 2019, and checked references and contacted study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) comparing the efficacy in terms of clinical outcomes of semen preparation techniques used for subfertile couples undergoing IUI. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. The primary review outcomes are live birth rate and clinical pregnancy rate per couple. MAIN RESULTS We included seven RCTS in the review; we included six of these, totalling 485 couples, in the meta-analysis. No trials reported the primary outcome of live birth. The evidence was of very low-quality. The main limitations were (unclear) risk of bias, signs of imprecision and inconsistency in results among studies and the small number of studies/participants included.Swim-up versus gradient technique Considering the quality of evidence, we are uncertain whether there was a difference between clinical pregnancy rates (CPR) for swim-up versus a gradient technique (odds ratio (OR) 0.83, 95% CI 0.51 to 1.35; I² = 71%; 4 RCTs, 370 participants; very low-quality evidence). The results suggest that if the chance of pregnancy after the use of a gradient technique is assumed to be 24%, the chance of pregnancy after using the swim-up technique is between 14% and 30%. We are uncertain whether there was a real difference between ongoing pregnancy rates per couple (OR 0.39, 95% CI 0.19 to 0.82; heterogeneity not applicable; 1 RCT, 223 participants; very low-quality evidence). Considering the quality of evidence, we are uncertain whether there was a difference between multiple pregnancy rates (MPR) per couple comparing a swim-up versus gradient technique (MPR per couple 0% versus 0%; 1 RCT, 25 participants; very low-quality of evidence). Considering the quality of evidence, we are also uncertain whether there was a difference between miscarriage rates (MR) per couple comparing a swim-up versus gradient technique (OR 0.85, 95% CI 0.28 to 2.59; I² = 44%; 3 RCTs, 330 participants; very low-quality evidence). No studies reported on ectopic pregnancy rate, fetal abnormalities or infection rate.Swim-up versus wash techniqueConsidering the quality of evidence, we are uncertain whether there is a difference in clinical pregnancy rates after a swim-up technique versus wash and centrifugation (OR 0.41, 95% CI 0.15 to 1.13; I² = 55%; 2 RCTs, 78 participants; very low-quality evidence). The results suggest that if the chance of pregnancy after the use of a wash technique is assumed to be 38%, the chance of pregnancy after using the swim-up technique is between 9% and 41%. Considering the quality of evidence, we are uncertain whether there was a difference between multiple pregnancy rates between swim-up technique versus wash technique (OR 0.49, 95% CI 0.02 to 13.28; heterogeneity not applicable; 1 RCT, 26 participants; very low-quality evidence). Miscarriage rate was only reported by one study: no miscarriages were reported in either treatment arm. No studies reported on ongoing pregnancy rate, ectopic pregnancy rate, fetal abnormalities or infection rate.Gradient versus wash techniqueConsidering the quality of evidence, we are uncertain whether there is a difference in clinical pregnancy rates after a gradient versus wash and centrifugation technique (OR 1.78, 95% CI 0.58 to 5.46; I² = 52%; 2 RCTs, 94 participants; very low-quality evidence). The results suggest that if the chance of pregnancy after the use of a wash technique is assumed to be 13%, the chance of pregnancy after using the gradient technique is between 8% and 46%. Considering the quality of evidence, we are uncertain whether there was a difference between multiple pregnancy rates per couple between the treatment groups (OR 0.33, 95% CI 0.01 to 8.83; very low-quality evidence). Considering the quality of evidence, we are also uncertain whether there was a difference between miscarriage rates per couple between the treatment groups (OR 6.11, 95% CI 0.27 to 138.45; very low-quality evidence). No studies reported on ongoing pregnancy rate, ectopic pregnancy rate, fetal abnormalities or infection rate. AUTHORS' CONCLUSIONS There is insufficient evidence to recommend any specific semen preparation technique: swim-up versus gradient versus wash and centrifugation technique. No studies reported on live birth rates. Considering the quality of evidence (very low), we are uncertain whether there is a difference in clinical pregnancy rates, ongoing pregnancy rates, multiple pregnancy rates or miscarriage rates per couple) between the three sperm preparation techniques. Further randomised trials are warranted that report live birth data.
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Affiliation(s)
- Carolien M. Boomsma
- Bravis HospitalObstetrics and GynaecologyBoerhaaveplein 1Bergen op ZoomNetherlands4624 VT
| | - Ben J Cohlen
- Isala Clinics, Location SophiaDepartment of Obstetrics and GynaecologyDr van Heesweg 2Isala ZwolleNetherlands
| | - Cindy Farquhar
- University of AucklandDepartment of Obstetrics and GynaecologyFMHS Park RoadGraftonAucklandNew Zealand1003
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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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22
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Vaughan DA, Sakkas D. Sperm selection methods in the 21st century. Biol Reprod 2019; 101:1076-1082. [DOI: 10.1093/biolre/ioz032] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 02/05/2019] [Accepted: 02/21/2019] [Indexed: 12/30/2022] Open
Abstract
Abstract
Natural sperm selection in humans is a rigorous process resulting in the highest quality sperm reaching, and having an opportunity to fertilize, the oocyte. Relative to other mammalian species, the human ejaculate consists of a heterogeneous pool of sperm, varying in characteristics such as shape, size, and motility. Semen preparation in assisted reproductive technologies (ART) has long been performed using either a simple swim-up method or density gradients. Both methodologies provide highly motile sperm populations; however neither replicates the complex selection processes seen in nature. A number of methods have now been developed to mimic some of the natural selection processes that exist in the female reproductive tract. These methods attempt to select a better individual, or population of, spermatozoa when compared to classical methods of preparation. Of the approaches already tested, platforms based upon sperm membrane markers, such as hyaluronan or annexin V, have been used to either select or deselect sperm with varied success. One technology that utilizes the size, motility, and other characteristics of sperm to improve both semen analysis and sperm selection is microfluidics. Here, we sought to review the efficacy of both available and emerging techniques that aim to improve the quality of the sperm pool available for use in ART.
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Affiliation(s)
- Denis A Vaughan
- Boston IVF, Waltham, Massachusetts, USA
- Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, Massachusetts, USA
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23
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Tarozzi N, Nadalini M, Borini A. Effect on Sperm DNA Quality Following Sperm Selection for ART: New Insights. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1166:169-187. [DOI: 10.1007/978-3-030-21664-1_10] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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24
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Ziarati N, Tavalaee M, Bahadorani M, Nasr Esfahani MH. Clinical outcomes of magnetic activated sperm sorting in infertile men candidate for ICSI. HUM FERTIL 2018; 22:118-125. [DOI: 10.1080/14647273.2018.1424354] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Niloofar Ziarati
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Marziyeh Tavalaee
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mehrnoosh Bahadorani
- Department of Biology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
| | - Mohammad Hossein Nasr Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
- Isfahan Fertility and Infertility Center, Isfahan, Iran
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