P-004 Optimizing Sperm Selection and Reproductive outcomes by Magnetic Cell Sorting (MACS) for Couples with Raised DFI

Abstract Study question For couples with raised sperm DNA Fragmentation (SDF), can sperm processing by MACS help in optimizing reproductive outcomes? Summary answer In couples with raised SDF, sperm processing by MACS seems to have limited role in optimizing reproductive outcomes. What is known already Raised SDF is known to affect the reproductive outcomes of a couple. Interventions that help in optimizing sperm selection process to negate the negative effects of SDF are still elusive and needs further research. Hence, we intend to evaluate the role of MACS to optimize sperm selection and reproductive outcomes in this study. Study design, size, duration This is a retrospective study during 2017-2020. Study group looked at couples with raised SDF>25% and were undergoing MACS(n = 65). Couples with raised SDF and had no MACS (underwent density gradient sperm preparation) was considered as control group (n = 30). All women in this study were<37 years and had atleast one failed IVF cycle. Men with sperm parameters >5m.ml and SDF>25% were considered in the study group. One failed IVF cycle was the indication for SDF testing Participants/materials, setting, methods Women underwent Controlled Ovarian Stimulation (COS) as per clinic’s Standard Operating Procedures (SOP). Semen on the day of oocyte retrieval were subjected to MACS and oocytes were injected with MACS separated sperm by ICSI. Embryos were cultured till the Blastocyst stage and then vitrified. In a frozen embryo transfer (FET) cycle two good grade blastocysts, with100%Survival were transferred. Implantation rates (IR), Miscarriage rates (MR), Multiple Pregnancy Rates (MPR) and Live Birth rates (LBR) were calculated Main results and the role of chance Reproductive Outcomes of MACS and Control groups were as follows: Blastocyst formation rates (BR) - 45.42 % vs 43 % (P = 0.827) IR - 47.1 % vs 42.30 % (p = 0.664) MR - 3.1 % vs 3.33 % (p = 0.95) MPR – 17% Vs 14% (p = 0.712) LBR - 73.8% Vs 56.6 (p = 0.0955) Reproductive outcomes between MACS and control group looked comparable. There was no statistical significance that was noted. Though LBR seemed high with MACS group there was no statistical significance. Double Density gradient for sperm processing also seems to be helping in optimizing sperm section with good quality DNA sperms and seems to offer similar reproductive outcomes. Data from this study doesn’t show encouraging role for MACS as a sperm processing method in men with raised SDF to optimize reproductive outcomes. Role of MACS to optimize sperm selection and Reproductive outcomes still needs further research. Limitations, reasons for caution This study had small sample size and unequal size, retrospective data evaluation and paternal age was not accounted. Wider implications of the findings A well-designed RCT to look for an ideal sperm processing technique, which offers sperms with good DNA quality and optimal reproductive outcomes, is the need of the hour and can shorten the time to conception Trial registration number N/A