使用微流控技术进行精子筛选可显著降低精子DNA碎片化（SDF），提高生殖结局：一项系统评价和荟萃分析。

Sperm Selection Using Microfluidic Techniques Significantly Decreases Sperm DNA Fragmentation (SDF), Enhancing Reproductive Outcomes: A Systematic Review and Meta-Analysis.

作者信息

Gisbert Iranzo Alma, Cano-Extremera Marina, Hervás Irene, Falquet Guillem Mar, Gil Juliá María, Navarro-Gomezlechon Ana, Pacheco-Rendón Rosa María, Garrido Nicolás

机构信息

IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Avenida Fernando Abril Martorell, 106-Torre A, Planta 1ª, 46026 Valencia, Spain.

出版信息

Biology (Basel). 2025 Jun 30;14(7):792. doi: 10.3390/biology14070792.

DOI:10.3390/biology14070792

PMID:40723352

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12292514/

Abstract

This study aimed to compare sperm parameters and reproductive outcomes after sperm selection using microfluidic chips versus conventional techniques (swim-up/density gradients). A systematic review and meta-analysis were performed after the extraction of relevant data from thirty-nine studies that met the inclusion criteria. Mean difference or odds ratio was calculated for each outcome. The analysis revealed that sperm selection using microfluidics yields lower sperm DNA fragmentation (MD = -9.98 [-13.19, -6.76], < 0.00001), increased progressive motility (MD = 14.50 [7.84, 21.71], = 0.04), total motility (MD = 10.68 [6.04, 15.31], < 0.00001) and morphology (MD = 1.41 [0.67, 2.16], = 0.0002). Significant differences were also found in the fertilization rate/MII oocyte microinjected (OR = 1.22 [1.01, 1.46], = 0.04), implantation rate/embryo transfer (ET) (OR = 4.51 [1.42, 14.37], = 0.01), clinical pregnancy/ET (OR = 1.73 [1.22, 2.45], = 0.002), ongoing pregnancy/ET (OR = 1.99 [1.03, 3.83], = 0.04), live birth rate/first cycle (OR = 1.59 [1.12, 2.24], = 0.009) and per all embryo transfer (OR = 1.65 [1.06, 2.55], = 0.03). No significant differences were found in embryo euploidy/number of biopsied blastocysts (OR = 1.34 [0.88, 2.04], = 0.77), biochemical pregnancy/ET (OR = 1.23 [0.84, 1.80], = 0.29), miscarriage rate/cycle (OR = 0.84 [0.54, 1.31], = 0.35) and per pregnancy (OR = 0.71 [0.50, 1.02], = 0.07), live birth rate/first embryo transfer (OR = 1.60 [0.80, 3.22], = 0.18) and per concluded cycle (OR = 1.03 [0.53, 2.00], = 0.92). To summarize, microfluidics may offer a beneficial approach in certain situations, particularly for patients with elevated sperm DNA fragmentation (SDF) levels. However, its integration into routine clinical practice cannot be justified yet in terms of cost-effectiveness. Additional research is needed to provide more comprehensive data on reproductive outcomes, especially live birth rates, which remain the ultimate goal of assisted reproductive technologies.

摘要

本研究旨在比较使用微流控芯片与传统技术（上浮法/密度梯度法）进行精子筛选后的精子参数和生殖结局。从39项符合纳入标准的研究中提取相关数据后，进行了系统评价和荟萃分析。计算每个结局的平均差或比值比。分析显示，使用微流控技术进行精子筛选可降低精子DNA碎片率（MD = -9.98 [-13.19, -6.76]，P < 0.00001），提高前向运动率（MD = 14.50 [7.84, 21.71]，P = 0.04）、总运动率（MD = 10.68 [6.04, 15.31]，P < 0.00001）和形态学正常率（MD = 1.41 [0.67, 2.16]，P = 0.0002）。在每个注射MII期卵母细胞的受精率（OR = 1.22 [1.01, 1.46]，P = 0.04）、每个胚胎移植（ET）的着床率（OR = 4.51 [1.42, 14.37]，P = 0.01）、每个ET的临床妊娠率（OR = 1.73 [1.22, 2.45]，P = 0.002）、每个ET的持续妊娠率（OR = 1.99 [1.03, 3.83]，P = 0.04）、每个首次周期的活产率（OR = 1.59 [1.12, 2.24]，P = 0.009）和每个所有胚胎移植的活产率（OR = 1.65 [1.06, 2.55]，P = 0.03）方面也发现了显著差异。在每个活检囊胚的胚胎整倍体率（OR = 1.34 [0.88, 2.04]，P = 0.77）、每个ET的生化妊娠率（OR = 1.23 [0.84, 1.80]，P = 0.29）、每个周期的流产率（OR = 0.84 [0.54, 1.31]，P = 0.35）和每个妊娠的流产率（OR = 0.71 [0.50, 1.02]，P = 0.07）、每个首次胚胎移植的活产率（OR = 1.60 [0.80, 3.22]，P = 0.18）和每个完成周期的活产率（OR = 1.03 [0.53, 2.00]，P = 0.92）方面未发现显著差异。总之，微流控技术在某些情况下可能提供一种有益的方法，特别是对于精子DNA碎片率（SDF）水平升高的患者。然而，就成本效益而言，将其纳入常规临床实践尚无充分理由。需要更多研究以提供关于生殖结局，尤其是活产率的更全面数据，活产率仍是辅助生殖技术的最终目标。