PGT-A Evaluates Advanced Sperm Selection in Embryos From High Teratozoospermia Males
Condition: Teratozoospermia; Sperm DNA Fragmentation; Infertility
MeSH terms: Infertility; Teratozoospermia
Study type: Interventional

Summary: 
      In this study of 264 couples, sperm selection techniques in males with high teratozoospermia
      index and sperm DNA fragmentation significantly increased fertilization, blastocyst
      development rates, and maintained comparable embryo euploidy rates through preimplantation
      genetic testing, suggesting the efficiency of these techniques in improving assisted
      reproductive outcomes.
    

Detailed description: 
      Couples seeking infertility treatment are becoming more frequent. Paternal factor shows one
      of the infertility causes which may have a negative impact on reproductive outcomes.
      Intracytoplasmic sperm injection (ICSI) is thought to be the most effective way to treat
      infertility. Sperm morphology evaluation is a reliable predictor of male fertility while
      teratozoospermia index (TZI) is a unique expression of sperm morphological assessment. A
      higher rate of abnormal sperm morphology tends to have higher sperm chromosomal abnormality
      rates. The choice of high-quality sperm through sperm selection techniques is expected to
      improve ICSI outcomes. In this study, a total number of 264 couples were included and divided
      into 3 groups: (1) Males have normal TZI (Control group: 111 males have TZI <1.6), (2) Males
      with high TZI and no sperm selection techniques are performed (NO-SS group: 63 males have TZI
      >1.8), and (3) Males with high TZI and sperm selection techniques are performed (SS-group: 90
      males have TZI >1.8). The TZI was significantly (P<0.000) higher in the NO-SS and SS-group as
      compared to the control group. The percentage of sperm DNA fragmentation SDF in the males of
      the SS group was significantly higher than the controls and NO-SS group (P=0.000). The
      fertilization (P=0. 039) and blastocyst development rates (P= 0. 041) are significantly
      higher in the SS group as compared to the NO-SS group in females aged <35. A total of 1072
      embryos were tested for preimplantation genetic testing for aneuploidy using NGS, although
      higher SDF in the males of the SS group, the embryo euploidy rates show that there is no
      significant difference between the SS group (56.35±3.46%) as compared to the control group
      (54.54±3.24%) and the NO-SS group (57.45±4.57%). In general, we found that sperm selection
      techniques are efficient techniques in increasing fertilization, blastocyst development
      rates, and euploidy rate in males with high teratozoospermia index and sperm DNA
      fragmentation combined.
    

Intervention name(s): Sperm Selection
Intervention type(s): Device
Intervention description(s): Sperm selection using physiological intracytoplasmic sperm injection (PICSI dish) or magnetic-activated cell sorting (MACS) for selecting sperm with high-quality, better morphology and lower DNA fragmentation.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Sperm selection; Teratozoospermia index; Sperm DNA fragmentation; PGT-A; Euploidy rate