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Gi. Julia M, Hervas I, Navarro-GomezLechon A, Quintana F, Amoros D, Pacheco A, Gonzalez-Ravina C, Rivera-Egea R, Garrido N. P–005 Magnetic-activated cell sorting in couples undergoing preimplantation genetic testing for aneuploidies (PGT-A) using autologous oocytes shows slightly lower aneuploidy rates compared to standard semen processing. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Does the selection of non-apoptotic sperm via magnetic-activated cell sorting (MACS) reduce the aneuploidy rate of embryos from couples undergoing ICSI cycles with PGT-A using the patients’ own oocytes?
Summary answer
It does. The aneuploidy rate in the MACS group was 4.34% lower than the one obtained using semen samples processed according to standard clinical practice.
What is known already
MACS is a successful tool in eliminating proapoptotic sperm from a semen sample. However, the true effect of this technique on reproductive outcomes and the quality of the resulting embryos are a matter of controversy. Some studies report that its use improves the percentage of good quality blastocysts in women older than 30 years old compared to standard ICSI. Randomized clinical trials that compare MACS to a control sample consider parameters of embryo quality such as morphology at day 3 or day 5, symmetry of the blastomeres, blastocysts’ stage of expansion, but they do not consider embryo ploidy.
Study design, size, duration
Retrospective, multicentre, observational cohort study. 14,145 patients and 18,710 cycles were evaluated in the reference group. In the MACS group, 615 patients and 974 cycles were considered. Data were exported from cycles performed in Spanish IVIRMA clinics between January 2008 and February 2020.
Participants/materials, setting, methods
Unselected males in couples undergoing PGT-A cycles, then subdivided into male factor (MF) - total progressive motile sperm count lower than 5 million - and non-male factor (NMF) infertility. Statistical analysis performed using R v.4.0.0. Means were calculated and compared using two-tailed paired t-test, while proportions were compared using Fisher’s exact test and the chi-squared test and the appropriate correction for multiple comparisons. The aneuploidy rates for each group were compared using Fisher’s exact test.
Main results and the role of chance
In the control group 73,228 biopsied embryos, from which 71,439 were informative in the PGT-A. In the MACS group 3,919 biopsied embryos, from which 3,843 were informative. The aneuploidy rate, computed per informative embryo, was 68.87% (68.40%, 69.34%) in the reference group and 64.53% (62.43%, 66.64%) in the MACS group. Both comparisons were statistically significant (p-value ˂0.00001). According to these results, an embryo in the PGT-A programme using non-apoptotic sperm selected through MACS and autologous oocytes had a 5% less chance of being aneuploid than those embryos fertilised with standardly selected sperm (relative risk of 0.95 (0.91–0.98) p = 0.006769). Embryos conceived from NMF patients whose semen had been processed using MACS had a 4.27% lower aneuploidy rate than the reference (65.52% (63.16%, 67.88%) vs 69.79% (69.20%, 70.37%) respectively). This difference was statistically significant. Those embryos conceived using semen from patients with MF using MACS also showed a lower aneuploidy rate than the reference with MF (0.28% (55.48%, 65.08%) vs (64.94% (63.35%, 66.23%) respectively), although this difference was not statistically significant. Thus, the decrease in aneuploidy rate observed when comparing MACS and reference groups undergoing PGT-A cycles using autologous oocytes remained approximately the same in both MF and NMF semen samples.
Limitations, reasons for caution
The retrospective nature of the study subjects the data to biases or inaccuracies in their annotation in the clinics’ informatic platform from which they were exported. However, the statistical analysis aimed at controlling these biases as much as possible.
Wider implications of the findings: The vast amount of data compiled for this study confirms that the selection of non-apoptotic sperm through MACS slightly decreases the aneuploidy rate of embryos compared to semen samples processed according to the clinics’ standards. This would be interesting for patients who are considering undergoing PGT-A cycles in the future.
Trial registration number
Not applicable
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Affiliation(s)
- M Gi. Julia
- IVI Foundation, Andrology and Male Infertility, Valencia, Spain
| | - I Hervas
- IVI Foundation, Andrology and Male Infertility, Valencia, Spain
| | | | - F Quintana
- IVIRMA Bilbao, Andrology Laboratory, Bilbao, Spain
| | - D Amoros
- IVIRMA Barcelona, Andrology Laboratory, Barcelona, Spain
| | - A Pacheco
- IVIRMA Madrid, Andrology Laboratory, Madrid, Spain
| | | | - R Rivera-Egea
- IVIRMA Valencia, Andrology Laboratory, Valencia, Spain
| | - N Garrido
- IVI Foundation, Andrology and Male Infertility, Valencia, Spain
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VILLANUEVA E, Gi. Julia M, lo. Santos JMD, Hervas I, Navarro-GomezLechon A, Rivera-Egea R, Garrido N. P–046 Application of hyperspectroscopy as a new sperm diagnostic and selection technique for ICSI based on hyperspectral signature of single spermatozoa – a proof of concept. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Is hyperspectral imaging of individual sperm cells an appropriate candidate technique with potential to identify molecular characteristics of single spermatozoa prior to microinjection?
Summary answer
Preliminary tests have allowed us to obtain the images, set up the methodology and the correct segmentation of each sperm into its signature spectra.
What is known already
Although image techniques such as fluorescence microscopy and Raman spectroscopy have been used to identify biomarkers on sperm cells, their translation to the fertility clinic is highly complex and unfeasible. Hyperspectroscopy has not yet been introduced in the reproductive field, but it has been successfully used in other medical disciplines to differentiate cell types or pathological versus healthy tissue. It relies on the combination of information from optical images and electromagnetic spectra produced by cells at different wavelengths. Therefore, it is an interesting candidate for objective non-destructive sperm selection before ICSI according to the presence of specific biomarkers.
Study design, size, duration
Pilot, prospective, observational study in the IVIRMA Valencia fertility clinic, designed as a proof of concept. Discarded semen samples were used for the technical setup and the preliminary tests of image acquisition. Hyperspectral images were obtained of 12 spermatozoa: two sperm cells were imaged 10 times each, while the other 10 sperm were imaged one time each.
Participants/materials, setting, methods
Samples were prepared on glass-bottom ICSI plates in PVP droplets according to routine clinical practice. Images were obtained using the camera HinaLea 4200M coupled to the Olympus IX73 inverted microscope. Hypercubes were extracted using MATLAB 2016a, and the most informative wavelength was chosen. Matrox Copilot software was used to process images and select the regions of interest (ROI) equivalent to one sperm. MATLAB was used to obtain the information for the pixels within each ROI.
Main results and the role of chance
Hypercube size for each image was 608x968x299 pixels. Each hypercube obtained provided information for 299 different wavelengths, from 402.8 to 998.3 nm. Once the hypercubes were obtained from each image, the spectra at 520 nm wavelength was selected as the one at which the pixel provided the most information. The background of each uploaded image was successfully removed by creating a mask, which was then used to extract and characterize all the spectra from each pixel of each sperm image. The result of this proof of concept, though measure qualitatively, is that the information obtained from hyperspectral imaging of individual sperm is highly reproducible and successful in showing overlapping spectra resulting from 10 different images of the same specimen. Spectra resulting from images of different sperm cells showed tangible differences on their composition demonstrating unique biochemical features of each. The next step will be to quantitatively measure the reproducibility and sensitivity of the technique in a larger sample, to then study the potential of single sperm hyperspectral imaging as a sperm selection tool for ICSI.
Limitations, reasons for caution
These are preliminary results obtained from the development of an appropriate methodology to adapt the acquisition of hyperspectral images in the clinic’s IVF laboratory. Thus, the group will continue to evaluate the reproducibility, sensitivity, and informative capability of the technique before contemplating its use on samples destined to perform cycles.
Wider implications of the findings: Having developed a laboratory and image processing methodology that allows us to successfully segment each obtained image according to the hyperspectral information of every pixel of each individual sperm, we could move forward in testing the potential of these hyperspectral signatures to identify sperm markers related to successful reproductive outcomes.
Trial registration number
Not applicable
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Affiliation(s)
| | - M Gi. Julia
- IVI Foundation, Andrology and Male Infertility, Valencia, Spain
| | | | - I Hervas
- IVI Foundation, Andrology and Male Infertility, Valencia, Spain
| | | | - R Rivera-Egea
- IVIRMA Valencia, Andrology Laboratory, Valencia, Spain
| | - N Garrido
- IVI Foundation, Andrology and Male Infertility, Valencia, Spain
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