Düşük Sperm Konsantrasyonu Olan Hastalarda Tüp Bebek Döngülerinde Sperm Seçiminde Mikroakışkan Kanal Sistemi Kullanmanın Klinik Sonuçlarının Değerlendirilmesi

Year 2023, Volume: 15 Issue: 1, 9 - 15, 15.03.2023

Özcan Budak , Mehmet Sühha Bostancı , Osman Köse , Nermin Akdemir , Ahmet Gökçe , Serhan Cevrioğlu

https://doi.org/10.18521/ktd.1171576

Abstract

Amaç: Yeni nesil bir yöntem olan mikroakışkan kanal sistemi (MAC), daha düşük DNA fragmantasyon indekslerine sahip daha kaliteli spermatozoa seçme şansı vermektedir. Bu çalışmada MAC tekniğinin erkek faktörleri nedeniyle ICSI-ET uygulanan hastalarda tedavi sonuçları değerlendirilmiştir.

Gereç ve Yöntem: Çalışmamız Sakarya Üniversitesi ART Merkezinde retrospektif olarak gerçekleştirdi. Çalışmamıza 35 erkek faktörü endikasyonu olan hastalar dahil edildi. Bu hastalarda, ardışık iki IVF döngüsünün ilkinde swim-up (SU), ikincisinde MAC sperm hazırlama tekniği kullanıldı. Çalışmamızda fertilizasyon, kaliteli embriyo sayısı,embriyo transferi sonrası implantasyon, gebelik oranları, beşinci gün embriyo sayısı ve dondurulmuş embriyo sayıları karşılaştırılmıştır.

Bulgular: Döllenme oranı MAC grubunda SU grubuna göre daha yüksekti (P=0.009). MAC grubundaki 3. ve 5. Gün Grade 1 embriyo sayısı SU grubuna göre istatistiksel olarak daha yüksekti (her iki parametre için p=0.000). 5. günde dondurulan kaliteli embriyo sayısı MAC grubunda SU grubuna göre daha yüksekti (P=0.000).

Sonuç: Erkek faktörü olan tüp bebek sikluslarında MAC uygulamasının implantasyon ve gebelik üzerine istatistiksel olarak anlamlı bir katkı sağlamadığını düşünmekteyiz.. Ancak fertilizasyon oranı ve embriyo kalitesini olumlu yönde etkileyebileceğini düşünmekteyiz. Ayrıca döngü sonunda dondurulan embriyo sayısını arttırdığını ve bu nedenle MAC tekniğinin tüp bebek tedavilerine olumlu katkı sağlayabileceğini düşünüyoruz

Keywords

Embriyo implantasyonu, İnfertilite, Mikroakışkan

Supporting Institution

DESTEKLEYEN KURUM YOK

Project Number

-----

Evaluation Of The Clinical Results Of Using Microfluidic Channel System For Sperm Selection In IVF Cycles In Patients With Low Sperm Concentration

Abstract

Objective: Microfluidic channel system (MAC), a new generation method, gives the chance to select better quality spermatozoa with lower DNA fragmentation indices. This study evaluated the treatment results in patients who underwent ICSI-ET due to the MAC technique's male factors.

Methods: Sakarya University ART Center carried out this retrospective study. Patients with 35 male factor indications were included in our study. In these patients, swim-up (SU) was used in the first of two consecutive IVF cycles, and the MAC sperm preparation technique was used in the second. Our study compared fertilization, quality embryo counts, implantation after fresh embryo transfer, pregnancy rates, fifth-day embryo, and frozen embryo numbers.

Results: Fertilization rate was higher in the MAC group than in the SU group (P=0.009). The number of 3rd and 5th Day Grade 1 embryo in the MAC group was statistically higher than in the SU group (p=0.000 for both parameters). The number of quality embryos frozen on day 5 was higher in the MAC group than in the SU group (P=0.000).

Conclusions: It is thought that MAC application does not make a statistically significant contribution on implantation and pregnancy in IVF cycles performed due to the malefactor. However, it may positively affect fertilization rate and embryo quality. In addition, we think that it increases the number of embryos frozen at the end of the cycle, and for this reason, the MAC technique may provide positive benefits to IVF treatments.

Keywords

Embryo implantation, infertility, microfluidics

Project Number

-----

References

• 1. Sakkas D, Ramalingam M, Garrido N, Barratt CL. Sperm selection in natural conception: what can we learn from Mother Nature to improve assisted reproduction outcomes? Hum Reprod Update. 2015;21(6):711-26.
• 2. Erdem A, Erdem M, Atmaca S, Korucuoglu U, Karabacak O. Factors affecting live birth rate in intrauterine insemination cycles with recombinant gonadotrophin stimulation. Reprod Biomed Online. 2008;17(2):199-206.
• 3. Zini A, Finelli A, Phang D, Jarvi K. Influence of semen processing technique on human sperm DNA integrity. Urology. 2000;56(6):1081-4.
• 4. Marchetti C, Obert G, Deffosez A, Formstecher P, Marchetti P. Study of mitochondrial membrane potential, reactive oxygen species, DNA fragmentation and cell viability by flow cytometry in human sperm. Hum Reprod. 2002;17(5):1257-65.
• 5. Sakkas D, Manicardi GC, Tomlinson M, Mandrioli M, Bizzaro D, Bianchi PG, et al. The use of two density gradient centrifugation techniques and the swim-up method to separate spermatozoa with chromatin and nuclear DNA anomalies. Hum Reprod. 2000;15(5):1112-6.
• 6. Ozcan P, Takmaz T, Yazici MGK, Alagoz OA, Yesiladali M, Sevket O, et al. Does the use of microfluidic sperm sorting for the sperm selection improve in vitro fertilization success rates in male factor infertility? J Obstet Gynaecol Res. 2021;47(1):382-8.
• 7. Asghar W, Velasco V, Kingsley JL, Shoukat MS, Shafiee H, Anchan RM, et al. Selection of functional human sperm with higher DNA integrity and fewer reactive oxygen species. Adv Healthc Mater. 2014;3(10):1671-9.
• 8. Zhang X, Khimji I, Gurkan UA, Safaee H, Catalano PN, Keles HO, et al. Lensless imaging for simultaneous microfluidic sperm monitoring and sorting. Lab Chip. 2011;11(15):2535-40.
• 9. Parrella A, Keating D, Cheung S, Xie P, Stewart JD, Rosenwaks Z, et al. A treatment approach for couples with disrupted sperm DNA integrity and recurrent ART failure. J Assist Reprod Genet. 2019;36(10):2057-66.
• 10. Samuel R, Feng H, Jafek A, Despain D, Jenkins T, Gale B. Microfluidic—based sperm sorting & analysis for treatment of male infertility. Translational Andrology and Urology. 2018:S336-S47.
• 11. World Health O. WHO laboratory manual for the examination and processing of human semen. 5th ed ed. Geneva: World Health Organization; 2010.
• 12. Mangoli E, Khalili MA, Talebi AR, Agha-Rahimi A, Soleimani M, Faramarzi A, et al. IMSI procedure improves clinical outcomes and embryo morphokinetics in patients with different aetiologies of male infertility. Andrologia. 2019;51(8):e13340.
• 13. Halvaei I, Khalili MA, Razi MH, Agha-Rahimi A, Nottola SA. Impact of different embryo loading techniques on pregnancy rates in in vitro fertlization/embryo transfer cycles. J Hum Reprod Sci. 2013;6(1):65-9.
• 14. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11(3):307-11.
• 15. Lara-Cerrillo S, Ribas-Maynou J, Rosado-Iglesias C, Lacruz-Ruiz T, Benet J, García-Peiró A. Sperm selection during ICSI treatments reduces single- but not double-strand DNA break values compared to the semen sample. Journal of Assisted Reproduction and Genetics. 2021;38(5):1187-96.
• 16. Samuel R, Feng H, Jafek A, Despain D, Jenkins T, Gale B. Microfluidic-based sperm sorting & analysis for treatment of male infertility. Transl Androl Urol. 2018;7(Suppl 3):S336-s47.
• 17. Gode F, Bodur T, Gunturkun F, Gurbuz AS, Tamer B, Pala I, et al. Comparison of microfluid sperm sorting chip and density gradient methods for use in intrauterine insemination cycles. Fertil Steril. 2019;112(5):842-8.e1.
• 18. Yalcinkaya Kalyan E, Can Celik S, Okan O, Akdeniz G, Karabulut S, Caliskan E. Does a microfluidic chip for sperm sorting have a positive add-on effect on laboratory and clinical outcomes of intracytoplasmic sperm injection cycles? A sibling oocyte study. Andrologia. 2019;51(10):e13403.
• 19. Yetkinel S, Kilicdag EB, Aytac PC, Haydardedeoglu B, Simsek E, Cok T. Effects of the microfluidic chip technique in sperm selection for intracytoplasmic sperm injection for unexplained infertility: a prospective, randomized controlled trial. J Assist Reprod Genet. 2019;36(3):403-9.
• 20. Gianaroli L, Magli MC, Ferraretti AP, Crippa A, Lappi M, Capitani S, et al. Birefringence characteristics in sperm heads allow for the selection of reacted spermatozoa for intracytoplasmic sperm injection. Fertil Steril. 2010;93(3):807-13.
• 21. Wang S, Ding L, Zhao X, Zhang N, Hu Y, Sun H. Embryo Selection for Single Embryo Transfer on Day 3 Based on Combination of Cleavage Patterns and Timing Parameters in in Vitro Fertilization Patients. J Reprod Med. 2016;61(5-6):254-62.
• 22. Awadalla M, Vestal N, McGinnis L, Ahmady A. Effect of Age and Morphology on Live Birth Rate After Cleavage Stage Embryo Transfer. Reprod Sci. 2021;28(1):43-51.
• 23. Glujovsky D, Farquhar C, Quinteiro Retamar AM, Alvarez Sedo CR, Blake D. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev. 2016(6):Cd002118.
• 24. Neyer A, Zintz M, Stecher A, Bach M, Wirleitner B, Zech NH, et al. The impact of paternal factors on cleavage stage and blastocyst development analyzed by time-lapse imaging-a retrospective observational study. Journal of assisted reproduction and genetics. 2015;32(11):1607-14.
• 25. Fernández-Shaw S, Cercas R, Braña C, Villas C, Pons I. Ongoing and cumulative pregnancy rate after cleavage-stage versus blastocyst-stage embryo transfer using vitrification for cryopreservation: Impact of age on the results. Journal of Assisted Reproduction and Genetics. 2015;32(2):177-84.
• 26. Wong KM, Mastenbroek S, Repping S. Cryopreservation of human embryos and its contribution to in vitro fertilization success rates. Fertility and Sterility. 2014;102(1):19-26.
• 27. Quinn MM, Jalalian L, Ribeiro S, Ona K, Demirci U, Cedars MI, et al. Microfluidic sorting selects sperm for clinical use with reduced DNA damage compared to density gradient centrifugation with swim-up in split semen samples. Hum Reprod. 2018;33(8):1388-93.
• 28. Carlini T, Paoli D, Pelloni M, Faja F, Dal Lago A, Lombardo F, et al. Sperm DNA fragmentation in Italian couples with recurrent pregnancy loss. Reprod Biomed Online. 2017;34(1):58-65.
• 29. Kumar K, Deka D, Singh A, Mitra DK, Vanitha BR, Dada R. Predictive value of DNA integrity analysis in idiopathic recurrent pregnancy loss following spontaneous conception. J Assist Reprod Genet. 2012;29(9):861-7.