Gil Juliá María, Hervás Irene, Navarro-Gómez Lechón Ana, Quintana Fernando, Amorós David, Pacheco Alberto, González-Ravina Cristina, Rivera-Egea Rocío, Garrido Nicolás
Andrology and Male Infertility Research Group, IVI Foundation-IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain.
IVIRMA Bilbao, Landabarri Bidea, 1-3, 2nd Floor, 48940 Leioa Bizkaia, Spain.
Biology (Basel). 2021 May 12;10(5):430. doi: 10.3390/biology10050430.
The application of MACS non-apoptotic sperm selection in infertility clinics is controversial since the published literature does not agree on its effect on reproductive outcomes. Therefore, it is not part of the routine clinical practice. Classical measures of reproductive success (pregnancy or live birth rates per ovarian stimulation) introduce a bias in the evaluation of a technique's effect, since only the best embryo is transferred. This retrospective, multicenter, observational study evaluated the impact of MACS on reproductive outcomes, measuring results in classical parameters and cumulative live birth rates (CLBR). Data from ICSI cycles using autologous oocyte in Spanish IVIRMA fertility clinics from January 2008 to February 2020 were divided into two groups according to their semen processing: standard practice (reference: 46,807 patients) versus an added MACS sperm selection (1779 patients). Only when measured as CLBR per embryo transferred and per MII oocyte used was the difference between groups statistically significant. There were no significant differences between MACS and reference groups on pregnancy and live birth rates. In conclusion, results suggest that non-apoptotic sperm selection by MACS on unselected males prior to ICSI with autologous oocytes has limited clinical impact, showing a subtle increase in CLBR per embryo transferred.
磁激活细胞分选技术（MACS）在不育症诊所中对非凋亡精子的筛选应用存在争议，因为已发表的文献对于其对生殖结局的影响尚未达成共识。因此，它并非常规临床实践的一部分。传统的生殖成功衡量指标（每次卵巢刺激的妊娠率或活产率）在评估一项技术的效果时会引入偏差，因为通常只移植最好的胚胎。这项回顾性、多中心、观察性研究评估了MACS对生殖结局的影响，采用传统参数和累积活产率（CLBR）来衡量结果。2008年1月至2020年2月西班牙IVIRMA生育诊所使用自体卵母细胞的卵胞浆内单精子注射（ICSI）周期数据，根据精液处理方式分为两组：标准操作组（参考：46,807例患者）和增加MACS精子筛选组（1779例患者）。仅当以每个移植胚胎和每个使用的成熟卵母细胞（MII）的CLBR来衡量时，两组之间的差异才具有统计学意义。MACS组与参考组在妊娠率和活产率方面没有显著差异。总之，结果表明，在使用自体卵母细胞进行ICSI之前，对未筛选男性进行MACS非凋亡精子筛选的临床影响有限，仅显示每个移植胚胎的CLBR略有增加。
