OBJECTIVE: To compare the quality of sperm samples obtained after density-gradient centrifugation and swim-up by performing a nuclear structural analysis with high magnification microscopy at ×8,000. DESIGN: Prospective and randomized split-sample study. SETTING: Reproductive Medicine Center. PATIENT(S): Sperm samples from 53 male-partners of couples undergoing infertility treatment. INTERVENTION(S): Samples were analyzed by high magnification microscopy before and after preparation and classified according the level of nuclear vacuolization. MAIN OUTCOME MEASURE(S): Recovery rate, motility rate and percentage of sperm scoring each of 4 grades of vacuolization in fresh and processed sample. RESULT(S): Both sperm processing methods, swim-up and density gradient centrifugation, allow the selection of sperm with lower nuclear vacuolization and presumably lower DNA fragmentation than the whole ejaculate. CONCLUSION(S): Swim-up produces samples with less vacuolization, but the recovery rate is also lower. The choice of processing technique would then depend on whether intrauterine insemination, IVF or ICSI/IMSI is to be performed. A prospective randomized study scoring fertility rates would be necessary to directly access the influence of these methods on the fertility outcome.
RCT Entities:
OBJECTIVE: To compare the quality of sperm samples obtained after density-gradient centrifugation and swim-up by performing a nuclear structural analysis with high magnification microscopy at ×8,000. DESIGN: Prospective and randomized split-sample study. SETTING: Reproductive Medicine Center. PATIENT(S): Sperm samples from 53 male-partners of couples undergoing infertility treatment. INTERVENTION(S): Samples were analyzed by high magnification microscopy before and after preparation and classified according the level of nuclear vacuolization. MAIN OUTCOME MEASURE(S): Recovery rate, motility rate and percentage of sperm scoring each of 4 grades of vacuolization in fresh and processed sample. RESULT(S): Both sperm processing methods, swim-up and density gradient centrifugation, allow the selection of sperm with lower nuclear vacuolization and presumably lower DNA fragmentation than the whole ejaculate. CONCLUSION(S): Swim-up produces samples with less vacuolization, but the recovery rate is also lower. The choice of processing technique would then depend on whether intrauterine insemination, IVF or ICSI/IMSI is to be performed. A prospective randomized study scoring fertility rates would be necessary to directly access the influence of these methods on the fertility outcome.
Authors: M Zarei-Kheirabadi; E Shayegan Nia; M Tavalaee; M R Deemeh; M Arabi; M Forouzanfar; Gh R Javadi; M H Nasr-Esfahani Journal: J Assist Reprod Genet Date: 2011-12-20 Impact factor: 3.412