P-005 Optimizing Sperm Selection and Reproductive outcomes by Microfluidics for Couples with Raised DFI
Authors: Kandru S , Mantravadi K.C , Gedela D.R 
Published: June 2022

Abstract

Study question
For couples with raised sperm DNA Fragmentation (SDF), can sperm processing by Microfluidics help optimize reproductive outcomes?

Summary answer
In couples with raised SDF, sperm processing by Microfluidics seems to have limited role in optimizing reproductive outcomes

What is known already
Raised SDF is known to affect the reproductive outcomes for a couple. As the interventions which help optimize sperm selection process in order to negate the harmful effects of SDF are still vague, further research in this area is warranted. Hence, we aim to assess the role of Microfluidics as an intervention to optimize sperm selection and reproductive outcomes in this study.

Study design, size, duration
This is a retrospective study during 2016-2020. Study group(n = 38) looked at couples with raised SDF&gt;25% and who underwent Microfluidics. The control group(n = 30) were couples with raised SDF with no Microfluidics. (Underwent density gradient sperm preparation). Women in this study were &lt;37 years and had at least one failed IVF cycle. Men who had sperm parameters &gt;5m/ml and SDF &gt;25% were considered in the study group. One failed IVF cycle was the indication for SDF testing.

Participants/materials, setting, methods
Women underwent Controlled Ovarian Stimulation (COS) as per clinic’s Standard Operating Procedure(SOP). Semen on the day of oocyte retrieval were subjected to Microfluidics and oocytes were injected with Microfluidics separated sperm by ICSI. Embryos were cultured till Blastocyst stage and then vitrified. In a frozen embryo transfer (FET) cycle, two good grade blastocysts with 100% survival were transferred. Implantation rates (IR), Miscarriage rates (MR), Multiple Pregnancy Rates (MPR) and Live Birth rates (LBR) were calculated.

Main results and the role of chance
Reproductive Outcomes of Microfluidics and Control groups were as follows:
Blastocyst formation rates (BR) - 46 % vs 43 % (P = 0.806)
IR - 47.7 % vs 42.30 % (p = 0.659)
MR – 7.8 % vs 3.33 % (p = 0.438)
MPR – 18.4 % Vs 16.6 % (p = 0.847)
LBR – 63.14 % Vs 56.6 % (p = 0.587)
The reproductive outcomes between Microfluidics and Control group seemed comparable. No statistical significance was noted between both groups. Although LBR seemed to be higher with the Microfluidics (study) group, there was no statistical significance.
Double Density gradient for sperm processing also seems to be helping in optimizing sperm selection with good quality DNA sperms, hence resulting in similar reproductive outcomes.
Data from this study seems to indicate that the role of Microfluidics as an intervention for sperm selection, in men with raised SDF, to optimize reproductive outcomes is limited.
Role of Microfluidics to optimize sperm selection and Reproductive outcomes needs more widespread research.

Limitations, reasons for caution
This study has a small and unequal sample size, retrospective data evaluation and paternal age was not taken into consideration.

Wider implications of the findings
A non-invasive method for couples with raised SDF which can provide sperms with good quality DNA in order to optimize reproductive outcomes and improve the probability of conception is crucial.

Trial registration number
N/A