title: Magnetic cell sorting of semen containing spermatozoa with high DNA fragmentation in ICSI cycles decreases miscarriage rate.
abstract: This retrospective cohort study investigated whether reproductive outcome could be improved in couples presenting with a high level of sperm DNA fragmentation (SDF) by treating the ejaculate with the magnetic cell sorting (MACS) sperm selection procedure in combination with prior density gradient centrifugation (DGC). Only men presenting with ≥30% sperm DNA in the ejaculate were included because these patients can be potentially treated with MACS to reduce the proportion of sperm presenting DNA damage. In total, 305 couples were included in this study, and from these, 216 women underwent autologous ICSI (AUTO-ICSI), whereas the remaining 89 participated in oocyte donor ICSI (DONOR-ICSI). Ejaculates were collected and DGC treated with and without MACS. Live birth and miscarriage rates resulting from ICSI observed after clinical pregnancy were determined. Sperm selection using DGC or a combination of DGC and MACS did not show any statistical difference with respect to live birth rate of couples undergoing either AUTO-ICSI or DONOR-ICSI, irrespective of whether the couples had a moderate (≥30 to <50%) or high (≥50%) level of SDF. Remarkably, there was no evidence of miscarriage in either cohort of patients (AUTO-ICSI or DONOR-ICSI) following the MACS procedure.
authors.affiliation: GINEMED, Farmacéutico Murillo Herrera, 3, Sevilla 41010, Spain.
authors.forename: Pascual
authors.initials: P
authors.lastname: Sánchez-Martín
authors.affiliation: GINEMED, Farmacéutico Murillo Herrera, 3, Sevilla 41010, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Dorado-Silva
authors.affiliation: GINEMED, Farmacéutico Murillo Herrera, 3, Sevilla 41010, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Sánchez-Martín
authors.affiliation: GINEMED, Farmacéutico Murillo Herrera, 3, Sevilla 41010, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: González Martínez
authors.affiliation: School of Agriculture and Food Science, The University of Queensland, Gatton 4070, Australia.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Johnston
authors.affiliation: Unit of Genetics, Department of Biology, Universidad Autónoma de Madrid, Madrid 20849, Spain. Electronic address: jaime.gosalvez@uam.es.
authors.forename: Jaime
authors.initials: J
authors.lastname: Gosálvez
mesh_terms: D002469:Cell Separation; D053938:DNA Fragmentation; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D012189:Retrospective Studies; D012661:Semen / Q000166:cytology*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000166:cytology* / Q000378:metabolism
keywords: Density gradient centrifugation; ICSI; Magnetic cell sorting (MACS); Male factor; Miscarriage; Sperm DNA fragmentation