title: Removal of annexin V-positive sperm cells for intracytoplasmic sperm injection in ovum donation cycles does not improve reproductive outcome: a controlled and randomized trial in unselected males.
abstract: OBJECTIVE
  To determine the effect of removing presumptive apoptotic sperm cells from samples from unselected males by means of magnetic activated cell sorting (MACS) on live-birth delivery rates after intracytoplasmic sperm injection (ICSI) in couples undergoing ovum donation (OD).
  
  
  METHODS
  Prospective, randomized, triple-blinded, and controlled study.
  
  
  METHODS
  Private university-affiliated IVF center.
  
  
  METHODS
  A total of 237 infertile couples undergoing ICSI as part of an OD program.
  
  
  METHODS
  Semen specimens from the control group were prepared by swim-up. Samples from the study group were prepared by swim-up followed by MACS and incubation with annexin V-conjugated microbeads to remove annexin V-positive (AV+) sperm cells.
  
  
  METHODS
  Fertilization rates, morphological features of early embryo development, implantation rates, ongoing pregnancy rates, and live-birth rates.
  
  
  RESULTS
  Similar results were obtained between groups for all the parameters compared: fertilization rates of 75.3% (95% confidence interval [CI], 71.6-78.9) versus 72.1% (95% CI, 68.6-75.7); percentage of good-quality embryos on day 2 of 53.7% (95% CI, 50.3-57.1) versus 51.8% (95% CI, 48.3-55.3) and on day 3 of 54.2% (95% CI, 50.7-57.6) versus 48.9% (95% CI, 45.3-52.4); implantation rates of 42.2% (95% CI, 33.8-48.1) versus 40.1% (95% CI, 34.8-49.6); positive beta-hCG tests of 63.2% (95% CI, 54.7-71.6) versus 68.6% (95% CI, 60.2-76.9), and live-birth rates of 48.4% (95% CI, 39.6-57.1) versus 56.4% (95% CI, 47.3-65.5) in the MACS versus control group. None of the differences reached statistical significance.
  
  
  CONCLUSIONS
  Applying MACS technology to remove AV+ sperm cells from unselected males does not improve the reproductive outcome of ICSI in OD.
authors.affiliation: Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain. Electronic address: Laura.Romany@ivi.es.
authors.forename: Laura
authors.initials: L
authors.lastname: Romany
authors.affiliation: Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain.
authors.forename: Nicolás
authors.initials: N
authors.lastname: Garrido
authors.affiliation: Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain.
authors.forename: Yamileth
authors.initials: Y
authors.lastname: Motato
authors.affiliation: Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Aparicio
authors.affiliation: Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Remohí
authors.affiliation: Instituto Universitario IVI Valencia, University of Valencia, Valencia, Spain.
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
mesh_terms: D000328:Adult; D017304:Annexin A5 / Q000378:metabolism*; D017209:Apoptosis; D001723:Birth Rate; D002469:Cell Separation / Q000379:methods*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008280:Magnetics; D008297:Male; D018587:Oocyte Donation; D010718:Phosphatidylserines / Q000378:metabolism; D011247:Pregnancy; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013079:Sperm Maturation / Q000502:physiology; D013094:Spermatozoa / Q000276:immunology* / Q000473:pathology
chemical_list: D017304:Annexin A5; D010718:Phosphatidylserines
keywords: Magnetic activated cell sorting, MACS; apoptotic sperm; live birth rate; ovum donation; sperm selection