Use of microfluidic sperm extraction chips as an alternative method in patients with recurrent in vitro fertilisation failure

Abstract

Purpose It is known that sperm preparation techniques in in vitro fertilisation (IVF) are intended to select the best-quality sperm. The aim of this study is to compare sperm the density gradient method and microfluidic chip (Fertile Plus) method in infertile patients by analysing fertilisation rates, pregnancy rates, and sperm morphology and DNA fragmentation rates posed by these two methods. Methods Using semen samples obtained from the patients, sperms were prepared with gradient (n = 312) and microfluidic chip methods (n = 116). Fertilisation and pregnancy rates were compared in the first time and in the recurrent IVF trial patients. In addition, the morphology and DNA fragmentation comparison of sperm samples were evaluated by Toluidine blue in situ chemical staining method. Results There was no statistically significant difference between fertilisation and pregnancy rates when compared with study groups in first-time IVF treatment patients. However, in recurrent IVF failure patients, there was a significant difference in fertilisation rates but no statistically significant difference was found in pregnancy rates. The microfluidic chip method significantly decreased sperm DNA fragmentation index according to density gradient method. Conclusions Microfluidic chip method may be recommended in patients with recurrent unsuccessful in vitro trials. The sperm DNA fragmentation test prior to the treatment will be helpful in selecting the appropriate sperm-washing method.

Sperm selection strategies and their impact on assisted reproductive technology outcomes

“…Yildiz and Yuksel compared the fertilisation and pregnancy rates following sperm selection through density gradient centrifugation or microfluidics chip systems in couples with unexplained infertility and recurrent unsuccessful IVF treatments, some interesting results were obtained (Yildiz & Yuksel, 2019). Although no difference was observed in the fertilisation and pregnancy rates in patients with unexplained infertility, the use of a microfluidic system significantly improved the fertilisation rate in couples who received at least two IVF treatments before the study, leading the authors to conclude that this method may be beneficial for patients with recurrent unsuccessful ART treatments.…”

Effect of Microfluidic Sperm Separation vs. Standard Sperm Washing Processes on Laboratory Outcomes and Clinical Pregnancy Rates in an Unselected Patient Population

“…It has been repeatedly demonstrated that the application of a microfluidic device for sperm sorting results in sperm with increased motility and significantly reduced DNA fragmentation [13,14,[23][24][25][26]. Considering these results, only a few studies have evaluated the effects of microfluidic sperm sorting on laboratory and cycle outcomes [4,15,16,18]. It is important to note that each of these studies employed the same microfluidic device as the present study [4,15,16,18].…”

“…It is important to note that each of these studies employed the same microfluidic device as the present study [4,15,16,18]. Three of these studies describe the use of the Fertile Chip and in markets outside of the United States, ZyMōt devices were known under the "Fertile" brand [4,16,18]. In April 2020, Fertile became known worldwide as the ZyMōt device.…”

“…Considering these results, only a few studies have evaluated the effects of microfluidic sperm sorting on laboratory and cycle outcomes [4,15,16,18]. It is important to note that each of these studies employed the same microfluidic device as the present study [4,15,16,18]. Three of these studies describe the use of the Fertile Chip and in markets outside of the United States, ZyMōt devices were known under the "Fertile" brand [4,16,18].…”

“…The most commonly employed sperm selection methods include density gradient centrifugation (DGC), direct swim-up, and swim-up wash. Each of these methods has their own limitations. The swim-up methods isolate a highly motile sperm population, but low numbers are often obtained [3,4]. Density gradient and swim-up wash methods employ centrifugation to form sperm pellets for the selective isolation of motile sperm from debris and the removal of seminal plasma by washing, respectively [3].…”