Cumulative live birth rates after IVF/ICSI cycles with sperm prepared by density gradient centrifugation vs. swim-up: a retrospective study using a propensity score-matching analysis

Abstract

Background Density gradient centrifugation (DGC) and swim-up (SU) are the two most widely used sperm preparation methods for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). However, existing comparisons of IVF/ICSI outcomes following these sperm preparation methods are insufficient and controversial. Methods This retrospective study included all first autologous IVF and ICSI cycles performed between March 1, 2016, and December 31, 2020 in a single university-based center. A total of 3608 cycles were matched between DGC and SU using propensity score (PS) matching for potential confounding factors at a ratio of 1:1. The primary outcome was the cumulative live birth rate (cLBR) per aspiration. Results PS matching provided 719 cycles after DGC and 719 cycles after SU. After adjusting for confounders, the recovery rate, progressive motility rate after sperm preparation, fertilization rate, good-quality embryo rate, and blastocyst formation rate were similar between the DGC and SU groups. The cLBR (odds ratio [OR] = 1.143, 95% confidence interval [CI]: 0.893–1.461) and LBR per transfer (OR = 1.082, 95% CI: 0.896–1.307) were also not significantly different between the groups. Furthermore, no significant differences were found in all of the laboratory and clinical outcomes following conventional IVF or ICSI cycles between the two groups. However, a significantly higher fertilization rate (β = 0.074, 95% CI: 0.008–0.140) was observed when using poor-quality sperm in the DGC group than in the SU group. Conclusions Sperm preparation using DGC and SU separately resulted in similar IVF/ICSI outcomes. Further studies are warranted to compare the effects of these methods on IVF/ICSI outcomes when using sperm from subgroups of different quality.

Can Microfluidics Improve Sperm Quality? A Prospective Functional Study

“…Currently, the most widely adopted methods in clinical practice for sperm selection are DGC and Swim-up. Multiple studies have asserted the similarity in results between these techniques [40,41]. The main objective of our current study is to functionally validate a novel sperm selection method, known as the SwimCount TM Harvester, based on microfluidics.…”

Levels of DNA accessibility in human sperm vary across individuals with differing reproductive parameters

“…Previous studies have found that swim-up is an effective approach to eliminate sperm with DNA fragmentation 51,52 , which we confirmed in our Nick translation results. Swim-up and density gradient centrifugation remain the two most used sperm preparation methods for clinical ART, with studies suggesting similar reproductive outcomes from both methods following intrauterine insemination 54 or IVF/ICSI 55 . The increase in highly accessible sperm following swim-up preparation may arise from two possible sources.…”

Spermatozoa isolation with Felix™ outperforms conventional density gradient centrifugation preparation in selecting cells with low DNA damage

“…[7][8][9] The respective efficacy of both spermatozoa preparation methods has been reported extensively. [10][11][12] Ultimately, it appears that both are equally efficient in achieving clinical pregnancies, 13 with DGC offering a better spermatozoa recovery rate particularly with asthenozoospermic, oligoasthenozoospermic, and oligoasthenoteratozoospermic specimens, the latter representing the vast majority of patients seen in infertility clinics.…”