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PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial
Eman Hasanen1, Khaled Elqusi2, Salma ElTanbouly2
1IVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt. em.saberh@gmail.com.
Journal of Assisted Reproduction and Genetics
|August 11, 2020
Summary
Physiological intracytoplasmic sperm injection (PICSI) and magnetic-activated cell sorting (MACS) are effective for sperm selection in cases of abnormal sperm DNA fragmentation. MACS shows better outcomes in younger women (<30), while PICSI is preferred for older women.
Area of Science:
- Reproductive Endocrinology
- Andrology
- Assisted Reproductive Technology
Background:
- Sperm DNA fragmentation (SDF) impacts ICSI outcomes.
- Selecting sperm with low SDF is crucial for successful fertilization.
- PICSI and MACS are advanced sperm selection techniques.
Purpose of the Study:
- To compare the efficacy of PICSI versus MACS for sperm selection in patients with abnormal SDF undergoing ICSI.
- To determine which technique yields better pregnancy rates.
Main Methods:
- A prospective randomized trial involving 413 ICSI cases with abnormal SDF (>20.3%).
- Patients were randomized to either PICSI (hyaluronan binding) or MACS (Annexin V magnetic beads).
- Key outcomes included pre-implantation embryological parameters and ongoing pregnancy rates.
Main Results:
- No significant differences in implantation or pregnancy rates between PICSI and MACS overall.
- MACS group showed significantly higher rates of good-quality blastocysts, clinical, and ongoing pregnancies in women <30 years.
- PICSI showed a trend towards higher rates in women aged 30-35, but not statistically significant.
Conclusions:
- Both PICSI and MACS are effective for sperm selection in patients with abnormal SDF.
- MACS is recommended for women under 30 years old.
- PICSI may be preferred for women over 30 years old.
