Morphokinetic parameters in sperm selection by Annexin-V sorting prior to ICSI in ovum donation program results from a prospective randomized trial

Magnetic activated cell sorting (MACS) procedure is able to separate reactive/positive sperm and inject no apoptotic spermatozoa in the oocyte. Our objective was to determine if MACS-Anexin V selection improved embryo morphokinetic parameters, development or implantation outcome, over the conventional swim-up technique. Secondary analysis from a prospective, randomized and double-blinded study. A total of 80 sperm samples from patients undergoing ovum donation were included. We generated two groups: MACS (Swim-up + MACS) and Swim-up group, before ICSI treatment. The MACS group included 37 couples and Swim-up 43. A total of 258 and 243 oocytes were analyzed respectively. With the use of Time-lapse technology we did a complete embryo follow-up until transfer with further morphokinetic analysis. Similar results were obtained in implantation rates in both groups 39.19% (CI95% 24.42_53.96) vs. 41.86% (CI95% 28.46_55.26). Direct division from 1 to 3 cells embryos incidence was 22.90% (CI95% 17.74_27.99) vs. 24.30% (CI95% 18.89_29.67) comparing MACS vs Swim-up groups respectively. Significant differences were found in morphokinetic parameters, particularly at cleavage stage embryos, results in MACS and Swim-up groups respectively were compared; t2: 27.05h (CI95% 26,54_27,56) vs. 28.55h (CI95% 27.98_29.12), t3: 37.11h (CI95% 36.26_37.95) vs. 38.62h (CI95% 37.69_39.55), t4: 39.71h (CI95% 38.85_40.57) vs. 42.04h (CI95% 40.97_43.11), t6: 54.50h (CI95% 53.18_55.82) vs. 51.69h (CI95% 50.45_52.92), t7_ 57.04h (CI95% 55.73_58.34) vs. 54.08h (CI95% 52.93_55.24). MACS technology application in unselected males undergoing ICSI on fertile donors affects cleavage stage embryos, results in faster cleaving embryos that may affect implantation potential. Further studied should be performed to understand the insights of this selection and whether this effect could be observed in the outcome by large scale studies.Tabled 1Morphokinetic parameters and statistical significance between groups (hours).MACS (95%CI)Swim-up (95%CI)Sig.t227.05h (26.54_27.56)28.55h (27.98_29.12)0.000t337.11h (36.26_37.95)38.62h (37.69_39.55)0.018t439.71h (38.85_40.57)42.04h (40.97_43.11)0.001t654.50h (53.18_55.82)51.69h (50.45_52.92)0.002t757.04h (55.73_58.34)54.08h (52.93_55.24)0.001 Open table in a new tab