Advanced Sperm Selection Strategies as a Treatment for Infertile Couples: A Systematic Review

Abstract

Assisted reproductive technology (ART) is an essential tool to overcome infertility, and is a worldwide disease that affects millions of couples at reproductive age. Sperm selection is a crucial step in ART treatment, as it ensures the use of the highest quality sperm for fertilization, thus increasing the chances of a positive outcome. In recent years, advanced sperm selection strategies for ART have been developed with the aim of mimicking the physiological sperm selection that occurs in the female genital tract. This systematic review sought to evaluate whether advanced sperm selection techniques could improve ART outcomes and sperm quality/functionality parameters compared to traditional sperm selection methods (swim-up or density gradients) in infertile couples. According to preferred reporting items for systematic reviews and meta-analyses (PRISMA guidelines), the inclusion and exclusion criteria were defined in a PICOS (population, intervention, comparator, outcome, study) table. A systematic search of the available literature published in MEDLINE-PubMed until December 2021 was subsequently conducted. Although 4237 articles were recorded after an initial search, only 47 studies were finally included. Most reports (30/47; 63.8%) revealed an improvement in ART outcomes after conducting advanced vs. traditional sperm selection methods. Among those that also assessed sperm quality/functionality parameters (12/47), there was a consensus (10/12; 83.3%) about the beneficial effect of advanced sperm selection methods on these variables. In conclusion, the application of advanced sperm selection methods improves ART outcomes. In spite of this, as no differences in the reproductive efficiency between advanced methods has been reported, none can be pointed out as a gold standard to be conducted routinely. Further research addressing whether the efficiency of each method relies on the etiology of infertility is warranted.

Spermbots and Their Applications in Assisted Reproduction: Current Progress and Future Perspectives

“…Besides genetic diagnosis, the key solutions are to develop advanced and strict sperm selection strategies considering the structural and physicochemical features. 77 , 78 Moreover, the recently emerging artificial intelligence (AI) based tools can also improve the outcomes of assisted fertilization. 79 Hence, the combination of in vitro technologies, spermbots, and AI tools will further open a new era for automated, intelligent and precise ART.…”

Male Infertility: A Retrospective Review of Laboratory Charts at a Tertiary Teaching Hospital in Nairobi City County

“…18 Technology for assisted reproduction, such as artificial insemination using donor sperm, intracytoplasmic sperm injection (ICSI), and in vitro fertilization (IVF) are other options for men affected with infertility. [19][20][21][22] Additionally modifications to one's lifestyle include maintaining a healthy weight, eating more fruits and vegetables, exercising regularly, controlling life stressors, and quitting alcohol, cigarettes, and non-prescription drug use. [23][24][25] By controlling reproductive hormones and improving blood flow to the uterus and ovaries, acupuncture can improve fertility.…”

Sperm Preparation with Microfluidic Sperm Sorting Chip May Improve Intracytoplasmic Sperm Injection Outcomes Compared to Density Gradient Centrifugation

“…Evaluating outcomes of MSS devices compared to other sperm preparation methods for ART is a relatively new area of research which has, so far, shown conflicting results [ 27 , 28 ].…”