title: Sperm selection using magnetic activated cell sorting (MACS) in assisted reproduction: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To determine whether the use of Magnetic Activated Cell Sorting (MACS) as a sperm selection technique improves ART success rates in couples undergoing assisted reproduction treatment.
  
  
  METHODS
  Systematic review and meta-analysis of prospective randomized trials. Two reviewers conducted study selection and data extraction independently.
  
  
  RESULTS
  Five studies (prospective randomized trials) that comprised 499 patients were included. Sperm selection using MACS resulted in statistically significant differences in pregnancy rates when compared with density gradient centrifugation and swim-up techniques (RR=1.50, 95 % CI 1.14-1.98). No differences were found between the groups according to the implantation (RR=1.03, 95 % CI 0.80-1.31) and miscarriage (RR=2.00, 95 % CI 0.19-20.90) rates.
  
  
  CONCLUSIONS
  MACS appears to be a safe and efficient method to select functional sperm with consistently good results. This technique may improve pregnancy rates when used to complement standard sperm selection methods in ART.
authors.affiliation: Hospital Universitari del Mar, Autonomous University of Barcelona, Barcelona, Spain. mgilco@cantv.net
authors.forename: Monica
authors.initials: M
authors.lastname: Gil
authors.forename: Valerie
authors.initials: V
authors.lastname: Sar-Shalom
authors.forename: Yolisid
authors.initials: Y
authors.lastname: Melendez Sivira
authors.forename: Ramon
authors.initials: R
authors.lastname: Carreras
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Checa
mesh_terms: D002469:Cell Separation / Q000379:methods; D053938:DNA Fragmentation; D010064:Embryo Implantation; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D027724:Reproductive Techniques, Assisted; D013094:Spermatozoa / Q000166:cytology*