Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Slajmerjeva 3, 1000, Ljubljana, SI, Slovenia.
J Assist Reprod Genet. 2018 Sep;35(9):1665-1674. doi: 10.1007/s10815-018-1242-1. Epub 2018 Jun 27.
The main aim of our study was to evaluate the benefit of the use of non-apoptotic spermatozoa selected by magnetic-activated cell sorting (MACS) for ICSI procedures for couples in which the women had good prognoses and the male factor of infertility was teratozoospermia.
Twenty-six couples were treated with ICSI after MACS selection of non-apoptotic spermatozoa following a sibling oocyte approach. Half of the oocytes were microinjected with conventionally prepared spermatozoa, and the other half were microinjected with non-apoptotic, MACS-selected spermatozoa. To assess the influence of MACS selection of spermatozoa on the outcomes of the ICSI cycles, the fertilization, embryo quality, pregnancy, and delivery rates were evaluated and compared between the sibling oocyte groups.
When subpopulations of couples according to female age were analyzed, a significant difference in quality of blastocyst was observed. More precisely, in a group that was treated with MACS-ICSI, a higher percentage of good quality blastocysts was found among women older than 30 years (75.0 vs. 33.3%; P = 0.028), while there was no difference among younger women. If all included couples were compared regardless of age, no significant difference was observed in the outcome of the ICSI/MACS-ICSI cycles in terms of oocytes and embryos. Additionally, after the ICSI and MACS-ICSI procedures, the morphologies of the prepared spermatozoa were compared. Results showed that the overall percentage of morphologically normal spermatozoa did not differ significantly between the ICSI and MACS-ICSI procedures. However, detailed analyses of the morphologically abnormal spermatozoa revealed significantly more spermatozoa with abnormal tails after MACS-ICSI procedure, which may be potential consequence of the selection procedure. Moreover, the trends towards less spermatozoa with abnormal heads and towards more spermatozoa with abnormal necks and midpieces after MACS-ICSI procedure were revealed, although the differences were not significant.
Couples dealing with male infertility due to teratozoospermia can benefit from MACS selection of spermatozoa with higher percentage of good quality blastocysts but only when the woman is older than 30 years.
我们研究的主要目的是评估通过磁激活细胞分选（MACS）选择非凋亡精子用于 ICSI 程序对女性预后良好且男性不育因素为畸形精子症的夫妇的益处。
26 对夫妇采用 MACS 选择非凋亡精子后进行 ICSI 治疗，采用同胞卵母细胞方法。一半的卵母细胞用常规制备的精子进行微注射，另一半用非凋亡、MACS 选择的精子进行微注射。为了评估 MACS 选择精子对 ICSI 周期结果的影响，评估并比较了同胞卵母细胞组之间的受精、胚胎质量、妊娠和分娩率。
当根据女性年龄分析亚组夫妇时，发现囊胚质量存在显著差异。更确切地说，在接受 MACS-ICSI 治疗的一组中，年龄大于 30 岁的女性中优质囊胚的比例更高（75.0%比 33.3%；P=0.028），而年轻女性则没有差异。如果比较所有包括的夫妇，无论年龄大小，ICSI/MACS-ICSI 周期的结果在卵母细胞和胚胎方面均无差异。此外，在 ICSI 和 MACS-ICSI 程序后，比较了准备好的精子的形态。结果表明，在 ICSI 和 MACS-ICSI 程序之间，形态正常精子的总百分比没有显著差异。然而，对形态异常精子的详细分析表明，MACS-ICSI 后异常尾的精子明显更多，这可能是选择程序的潜在后果。此外，虽然差异不显著，但也揭示了 MACS-ICSI 后异常头部的精子数量减少，异常颈部和中段的精子数量增加的趋势。
因畸形精子症导致男性不育的夫妇可以受益于 MACS 选择精子，其优质囊胚的百分比更高，但前提是女性年龄大于 30 岁。
