Migration-Gravity Sedimentation: An Effective Approach for Reducing Sperm DNA Fragmentation With Comparable...

To compare the efficacy of migration-gravity sedimentation (MGS) and density gradient centrifugation (DGC) for sperm preparation in intracytoplasmic sperm injection (ICSI) cycles, focusing on sperm DNA fragmentation (SDF) and ICSI outcomes.

In this prospective study, 32 patients who underwent ICSI using sibling oocytes were enrolled. Half of the oocytes were fertilized with DGC-prepared sperm and the other half with MGS-prepared sperm. Semen parameters were assessed using computer-assisted sperm analysis (CASA), and SDF levels were measured using the terminal deoxynucleotidyl transferase dUTP nick end labeling assay before and after sperm preparation. Fertilization, blastocyst development, and clinical pregnancy rates were compared between the two groups.

MGS significantly reduced SDF levels compared to raw semen and DGC. CASA demonstrated enhanced motility, straightness, and linearity with MGS, although curvilinear velocity, average path velocity, and amplitude of lateral head displacement were lower. Fertilization and clinical outcomes, including blastocyst formation and pregnancy rates, were comparable between the groups.

MGS is a simple, centrifuge-free, and low-cost sperm preparation technique that effectively reduces sperm DNA fragmentation and achieves ICSI outcomes similar to those of DGC. These findings indicate that MGS may be a viable alternative to assisted reproductive technology, specifically in patients without male-factor infertility.

This study was registered in the University Hospital Medical Information Network (UMIN000043585).