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Journal of Assisted Reproduction and Genetics

Erschienen in:

08.08.2020 | Gamete Biology

PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial

verfasst von: Eman Hasanen, Khaled Elqusi, Salma ElTanbouly, Abd ElGhafar Hussin, Hanaa AlKhadr, Hosam Zaki, Ralf Henkel, Ashok Agarwal

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 10/2020

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Abstract

Purpose

To know which sperm selection technique, physiological intracytoplasmic sperm injection (PICSI) or magnetic-activated cell sorting (MACS), is better for the selection of sperm with abnormal sperm DNA fragmentation (SDF) in patients undergoing intracytoplasmic sperm injection (ICSI).

Methods

A prospective randomized trial included 413 ICSI cases with abnormal SDF (> 20.3%) by TUNEL assay. Patients with at least 1 million total progressive motile sperm count were randomized to PICSI or MACS groups on the day of ICSI. PICSI depends on the hyaluronan binding of better SDF sperm where individual sperm was selected, while MACS selects non-apoptotic sperm population using Annexin V magnetic beads. All pre-implantation embryogenic parameters were observed and the main outcome was the ongoing pregnancy rate.

Results

There were no significant differences between patients allocated to PICSI and MACS in the studied parameters including pre-implantation embryological data, implantation, clinical pregnancy, and ongoing pregnancy rates. Meanwhile, sub-analysis according to the female age has shown that female patients with less than 30 years of age in the MACS group had significantly higher good-quality blastocyst, clinical pregnancy, and ongoing pregnancy rates than the PICSI group. However, the higher implantation (p = 0.051), clinical pregnancy (p = 0.078), and ongoing pregnancy (p = 0.097) rates observed in females between 30 and 35 years of age in the PICSI group did not reach significance level.

Conclusions

PICSI and MACS are efficient techniques for sperm selection in cases with abnormal sperm DNA fragmentation. However, MACS is preferred when the females are younger than 30 years, while PICSI is preferred in older females.

Clinical trial registration number

NCT03398317 (retrospectively registered)

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Titel: PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial
verfasst von: Eman Hasanen
Khaled Elqusi
Salma ElTanbouly
Abd ElGhafar Hussin
Hanaa AlKhadr
Hosam Zaki
Ralf Henkel
Ashok Agarwal
Publikationsdatum: 08.08.2020
Verlag: Springer US
Erschienen in: Journal of Assisted Reproduction and Genetics / Ausgabe 10/2020
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-020-01913-4

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PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial