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VOL. 2, ISSUE 2 (2020)
Magnetic-activated sperm enrichment (MASE) versus density gradient centrifugation (DGC) impact on ICSI outcome
Authors
Ahmed M Omar, Khaled S Raouf, Tarek ElGuindy, Nahla Kamel, Samar S Arafa, Abdelrahman A Gebril
Abstract
Background: Male factor infertility contributes to around 40% of the infertility clinical scenarios around the globe (Kumar N. & Singh A. K. 2015). Male infertility is usually reflected in semen analysis parameters. However, some core problems within the spermatozoa itself which does not reflect with just a simple semen analysis. One of the major debilitating core factors for such infertility is DNA fragmentation which can be described as DNA breakage reflecting nuclear damage that impacts embryonic molecular and cellular development course (Seli, E., Gardner, D.K., Schoolcraft, W.B., Moffatt, O., & Sakkas, D. 2004. Density gradient centrifugation (DGC) as a routine sperm preparation technique implemented as a diagnostic tool for overall reduction of bad quality spermatozoa but does not have a single selection per spermatozoon prior to ART (Sakkas, D., Manicardi, G.C., Tomlinson, M., Mandrioli, M., Bizzaro, D., Bianchi, P.G., & Bianchi, U. 2000). Magnetic Activated Sperm Enrichment (MASE), a new spermatozoa preparation for ART technique uses both Annexin V & lectins namely LCA and PNA to bind to the apoptotic, necrotic and malformed or damaged sperm acrosomal and glycocalyx regions (Sutovsky & Kennedy 2013). Such offers a single selection to spermatozoa for fertilization. Study aim is to compare between two processing techniques for spermatozoa in ICSI management cycles (MASE) vs (DGC). Factors for comparison included fertilization, cleavage rate, Blastocysts formed and confirmed pregnancies. Statistics performed using SPSS. Methodology: A prospective research study implemented at el nada IVF centre between February 2019 and September 2019 were 132 couples undergoing fertility treatments were included in the study. All cases showed only male factor infertility as all females were reported normal, their age ≤ 36 years, Normal basal FSH level, BMI ≤ 30, No uterine abnormalities, Not PCO syndrome, endometrial thickness ≥ 9 mm. sperm sample provided per case was split into 2 groups (group 1 processed with MASE and group 2 processed with DGC) for sperm selection prior to ICSI. Embryos per group were cultured under the same conditions. ET was randomized and split into 2 groups (66 per technology). Results: A total of 3066 oocytes were injected for the two groups, Magnetic Activated Sperm Enrichment (MASE) and Density gradient centrifugation (DGC) (mean +/- SD =11.88 ± 0.3 MASE group vs 11.05 ± 0.29 DGC group), overall enhancement to the quality of the embryos formed from spermatozoa sorted with magnetic activated sperm enrichment (MASE) in comparison to common density gradient column centrifugation (DGC) as regards fertilization rate (mean +/- SD =10.02 ± 0.24 MASE vs 9.08 ± 0.25 DGC) (p value =0.008), cleavage rate (mean +/- SD = 8.08 ± 0.2 MASE vs 6.9 ± 0.24 DGC)(p value =0.0001), Blastocysts formed (6.13 ± 0.19 MASE vs 4.86 ± 0.2 DGC) (p=0.00001), 5AA grade (4.07 ± 0.15 MASE vs 3.74 ± 0.15) were significant (p=0.0001) and in favour of MASE while fair grade embryos (5BA) for the MASE group (2.75 ± 0.24) versus DGC (2.81 ± 0.20) (p=0.0008). 53 confirmed pregnancies out of 66 (MASE) vs 35 out of 66 (DGC). Chi-square test was performed (0.05 significance), fisher's exact significance (0.002). Conclusion: MASE as a laboratory tool is a highly effective protocol for sperm selection in ICSI procedures in a statistically significant manner in comparison to DGC, however future research efforts are recommended to be conducted in a multicentric manner with larger sample sizes taking in consideration racial and ethnic differences of cases as response to the outcome.
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Pages:10-15
How to cite this article:
Ahmed M Omar, Khaled S Raouf, Tarek ElGuindy, Nahla Kamel, Samar S Arafa, Abdelrahman A Gebril "Magnetic-activated sperm enrichment (MASE) versus density gradient centrifugation (DGC) impact on ICSI outcome". International Journal of Gynaecology and Obstetrics Research, Vol 2, Issue 2, 2020, Pages 10-15
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