Ozcan Pinar, Takmaz Taha, Yazici Melis Gökce Kocer, Alagoz Oya Akcin, Yesiladali Mert, Sevket Osman, Ficicioglu Cem
Department of Obstetrics and Gynecology, Bezmialem University Faculty of Medicine, İstanbul, Turkey.
Department of Obstetrics and Gynecology, Yeditepe University Faculty of Medicine, İstanbul, Turkey.
J Obstet Gynaecol Res. 2021 Jan;47(1):382-388. doi: 10.1111/jog.14539. Epub 2020 Nov 16.
To evaluate the clinical outcome of assisted reproductive technology (ART) cycles in couple with male infertility, where the spermatozoa were selected using either a conventional gradient-density centrifugation technique or microfluidic sperm sorting.
A total of 181 patients who underwent in vitro fertilization (IVF) because of male factor infertility at the IVF center of Bezmialem and Yeditepe University Hospital were included in this study. All patients were divided into two groups according to the sperm selection method: group I (n = 91): microfluidic sperm-sorting chip; group II (n = 90): density-gradient centrifugation. Data collected included male and female age, type of infertility, duration of infertility, previous IVF attempts, smoking, antral follicle count, total dosage of gonadotropins, maximum estradiol levels, duration of stimulations, endometrial thickness on human chorionic gonadotropin day, total number of oocytes retrieved, number of mature oocytes retrieved, number of pronuclear (PN), sperm parameters, clinical PR and ongoing PR.
There was no statistically significant difference in clinical PR and ongoing PR between groups (49.5% vs 40%, P = 0.2; 44% vs 36.7%, P = 0.3; respectively). The improvement in pregnancy rate was more prominent in patients where the female partner's age is higher than 35 (P = 0.09) and men have a total motile sperm count between 1 and 5 million (P < 0.01).
Microfluidic devices, "labs-on-a-chip," are a disposable, easy to use, and inexpensive method for sperm sorting. Our results show that IVF success rates might improve with the use of a microfluidic sperm-sorting chip for sperm selection in male infertility.
评估采用传统梯度密度离心技术或微流控精子分选技术选择精子的男性不育夫妇辅助生殖技术（ART）周期的临床结局。
本研究纳入了181例因男性因素不育在贝兹米亚勒姆和耶迪特佩大学医院体外受精（IVF）中心接受治疗的患者。根据精子选择方法将所有患者分为两组：第一组（n = 91）：微流控精子分选芯片组；第二组（n = 90）：密度梯度离心组。收集的数据包括男女年龄、不孕类型、不孕持续时间、既往IVF尝试次数、吸烟情况、窦卵泡计数、促性腺激素总剂量、最高雌二醇水平、刺激持续时间、人绒毛膜促性腺激素日的子宫内膜厚度、回收的卵母细胞总数、回收的成熟卵母细胞数、原核（PN）数、精子参数、临床妊娠率（PR）和持续妊娠率。
两组之间的临床PR和持续PR无统计学显著差异（分别为49.5%对40%，P = 0.2；44%对36.7%，P = 0.3）。在女性伴侣年龄高于35岁（P = 0.09）且男性总活动精子数在100万至500万之间的患者中，妊娠率的改善更为显著（P < 0.01）。
微流控设备，即“芯片实验室”，是一种用于精子分选的一次性、易于使用且成本低廉的方法。我们的结果表明，在男性不育症中使用微流控精子分选芯片选择精子可能会提高IVF成功率。
