P-58: Which Novel Sperm Selection is Suitable for ICSI? MACS-DGC or DGC-MACS

Background: Super-paramagnetic annexin-V conjugated micro-beads are able to eliminate sperm with phosphatidylserine externalization (PSE). PSE is considered as apoptotic sperm. PES positive sperm can be removed from sperm preparations sample to enhance sperm quality for assisted medical procreation. Therefore, the efficiency of this technique over normal sperm processing procedure such as density gradient centrifugation (DGC) needs further verification. In addition, considering the fact that DGC induces EPS due to capacitation and acrosome reaction, therefore, the role of MACS before DGC (MACS-DGC) and MACS after DGC (DGCMACS) were assessed. Materials and Methods: Semen samples (n = 15) were collected from infertile individuals and were washed with Ham’s buffer and divided into three separate portions. A portion of the sample was kept as controls and a second portion was used for DGC-MACS (MACS procedure was carried out after DGC). The third portion was used for MACS-DGC (DGC procedure was carried out after MACS). Percentages of sperm with normal morphology, DNA fragmentation, protamine deficiency, EPS and caspase- 3 activity were determined in each group. Results: Combination of DGC and MACS improved the sperm quality compared to when DGC and MACS were implemented independently. However, comparison of the combined procedures showed only higher efficiency to separate active caspase in the MACS-DGC group. Conclusion: In spite of recent clinical trends in the literature, which are mainly implement DGC-MACS procedure, we strongly recommend MACS-DGC procedure.