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Title: [Magnetic-activated cell sorting (MACS) versus density gradient centrifugation (DGC) for the selection of human sperm in assisted reproductive techniques].
Author: Fang L, Ye YH, Li ES, Feng GF.
Journal: Zhonghua Yi Xue Za Zhi; 2018 Oct 30; 98(40):3263-3267. PubMed ID: 30392293.
Abstract:
Objective: To investigate whether the assisted reproductive techniques (ART) outcomes can be improved by using magnetic-activated cell sorting combined isolate density gradient centrifugation (MACS-DGC), and to compare the results with the conventional isolate density gradient centrifugation (DGC) method. Methods: In the period from January to December 2014, patients who attended the andrology laboratory for sperm DNA fragmentation analysis and underwent the in vitro fertilization and embryo transfer (IVF-ET) treatment were divided into 3 groups, and each group has two subgroups according to the way of fertilization : in vitro fertilization (IVF) as subgroup 1 and intracytoplasmic sperm injection (ICSI) as subgroup 2. Group A (A1, A2 ): DNA fragmentation index(DFI)≥20 and using MACs; Group B (B1, B2): DFI≥20 and using isolate method; Group C (C1, C2): DFI<20 and using isolate method. The fertilization rate, good-quality embryos, implantation rate, pregnancy rate and live-birth rate of each group were analyzed. Results: Similar results were obtained among groups for all the parameters compared: On IVF cycles no significant difference was observed in fertilization rate, percentage of good-quality embryos on day 3, implantation rate, positive beta-hCG tests, and live-birth rate among the three subgroups (A1 vs B1 vs C1). Between the subgroups of ICSI cycles (A2 vs B2 vs C2) the percentage of high-quality embryos, pregnancy rate, implantation rate and live-birth rate were all significantly higher in the MACS-DGC (A2) group compared to DGC alone (B2). Conclusion: Based on the results, MACS as a part of sperm preparation technique will not improve sperm fertilizing potential, embryos quality, implantation rate, pregnancy rate or live-birth rate of IVF, but it may help select the most fertile sperm and to improve clinical outcomes of ICSI. 目的： 比较新型磁珠分选法(MACS-DGC)与传统的密度梯度离心法(DGC)分离精子对辅助生殖(ART)结局的影响。 方法： 回顾分析2014年1至12月在浙江大学医学院附属妇产科医院生殖中心进行精子DNA碎片率(DFI)检测并进入体外受精-胚胎移植(IVF-ET)周期的病例。根据DFI将病例分为3组：DFI异常(DFI≥20)且使用新型精子磁珠分选法(A组)；DFI异常(DFI≥20)且使用传统精子密度梯度离心法(B组)；DFI正常(DFI<20)且使用传统精子密度梯度离心法(C组)。根据受精方式的不同，将常规体外受精(IVF)标记为1组，卵细胞质内单精子显微注射(ICSI)标记为2组。对各组的正常受精率、优胚率、临床妊娠率，胚胎种植率、抱婴率等临床结果进行统计分析。 结果： 在IVF三组中(A1、B1、C1)正常受精(2PN)率、优胚率、临床妊娠率，胚胎种植率、抱婴率差异均无统计学意义(均P>0.05)。在高DFI的ICSI患者(A2、B2)中，A2组对比B2组发现优胚率(87.8%比46.3%，P<0.001)、临床妊娠率(66.7%比29.2%，P＝0.031)、胚胎种植率(50.0%比19.5%，P＝0.010)、抱婴率(66.7%比25.0%，P＝0.016)差异均有统计学意义。 结论： 新型精子磁珠分选法对比传统梯度分离法对于IVF的临床结果差异无统计学意义，但在ICSI受精周期中临床结局得到了显著改善。.

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