Sperm preparation techniques in assisted reproductivetechnology

Abstract

Based on data from the World Health Organization, millions of couples around the world struggle with theproblem of infertility. Significantly reduced semen parameters are responsible for approximately 50% offailures to get pregnant. Semen preparation techniques for assisted reproduction procedures are intended toprepare a sample containing sperm with the greatest potential to fertilize an oocyte. Normal morphology, lowpercentage of DNA fragmentation (fDNA), fast and progressive sperm cell movement, low content of reactiveoxygen species (ROS) constitute the basis for the selection of reproductive cells in assisted reproductionlaboratories. The purpose of this study was to discuss and compare semen preparation techniques usedin assisted reproduction laboratories in terms of their effectiveness and application according to currentscientific reports. The selection of appropriate semen preparation should be based on a thorough diagnosisof male fertility with an in-depth analysis of semen analysis. According to the recommendations of scientificsocieties, supported by the analysis of huge databases in the field of embryology, techniques such as spermwashing, swim-up or density gradient centrifugation are recommended for use in routine clinical work.Additional procedures: magnetically activated cell sorting (MACS), IMSI (intracytoplasmic morphologicallyselected sperm injection), physiological ICSI (PICSI) are not recommended for common use. Onlymicrofluidic sperm selection (MSS) techniques should be considered for routine work after considering theappropriateness of its use. However, in the area of additional procedures, there is no clear and statisticallysignificant evidence regarding safety and increased effectiveness compared to standard, commonly usedsemen preparation techniques.