Póster Congreso ESHRE20: Fertile®Chip-ZyMōt improves ICSI clinical outcomes in patients with high values of sperm double-strand breaks using oocytes from both patients and donors

  • Fecha: July 2020. Congreso ESHRE 2020
  • Revista: ESHRE 2020
  • Autores: S. Camacho Fernandez-Pacheco, C. Urda-Muñoz , S. Lara-Cerrillo , T. Lacruz-Ruiz , C. Rosado-Iglesias , M. de la Casa Heras , V. Badajoz-Liébano , J. Gijón de la Santa , A. García-Peiró.


Study question: Are clinical outcomes on ICSI cycles improved by the use of Fertile®Chip-ZyMōt for sperm selection using oocytes from both patients and donors?

Summary answer: Fertile®Chip-ZyMōt improved biochemical and clinical pregnancy rates and reduced miscarriage rate in ICSI cycles from patients with altered values of dsSDF.

What is known already: Delays in embryo kinetics, implantation failures in ICSI treatments and recurrent miscarriages have been associated to high values of double-strand breaks (DSB) in sperm. Moreover, a recent study showed that DSB are not reduced during the sperm selection of an ICSI cycle. The Fertile®Chip-ZyMōt is a new method for sperm selection based on microfluidic properties that showed to reduce the presence of DSB in the sperm sample. In this sense, the specific reduction of DSB using Fertile®Chip-ZyMōt could improve clinical outcomes after ICSI treatments.

Study design, size, duration: This retrospective study included 78 ICSI cycles from January 2018 to March 2019. Three groups were classified attending on the origin of the oocytes and the sperm selection method: Control group = oocytes from patients and density gradients for sperm selection (n=16); Group 1 = oocytes from patients and Fertile®Chip-ZyMōt for sperm selection (n=22); and Group 2 = oocytes from donors and Fertile®Chip-ZyMōt for sperm selection (n=11). All male patients presented high values of DSB.

Participants/materials, setting, methods: Patients included in the study presented high values of DSB analyzed though the Neutral CometFertility assay (CIMAB, Spain). Sperm selection was performed using conventional Density Gradients (Sperm Grad, Vitrolife, Sweden) (Control group) or the Fertile®Chip-ZyMōt (DxNow, USA) (Groups 1 and 2). ICSI cycles were performed using oocytes from patients or donors and clinical outcomes were studied. Results were compared between groups, being the statistical significance α = 0,05.

Main results and the role of chance: Women’s age was significantly lower in Group 2 (26.7 ± 4.28) compared to the Control group (35.67 ± 3.43) and Group 1 (36.17 ± 3.84), p<0.01. Fecundation rates were slightly higher, even not significantly, in Group 1 (0.53 ± 0.27) and Group 2 (0.63 ± 0.21) compared to the Control group (0.51 ± 0.29), p=0.80. Biochemical pregnancy was significantly higher in Group 1 (12/22 (54.5%)) and Group 2 (7/11 (63.6%)), compared to the Control group (3/16 (18.8%), p=0.03. Clinical pregnancy was significantly higher in Group 1 (10/22 (45.5%)) and Group 2 (7/11 (63.6%)), compared to the Control group (2/16 (12.5%), p=0.01. Miscarriage rates were significantly higher in the Control group (2/2 (100%)) than in Group 1 (2/10 (20%)) and Group 2 (0/7 (0%)), p=0.02. Even Group 2 showed the best results, there were no significant differences compared to Group 1 for biochemical and clinical pregnancies and miscarriage rates ( p=0.618; p=0.325 and p=0.418, respectively). Compared to density gradients, the use of the Fertile®Chip-ZyMōt in ICSI cycles improved biochemical pregnancy rates x1,65 using oocytes from patients ( p=0,033) and x2,32 using oocytes from donors ( p=0,054). Fertile®Chip-ZyMōt also improved clinical pregnancy rates x1,71 using oocytes from patients and x2,68 oocytes from donors ( p=0,036).

Limitations, reasons for caution: Despite biochemical and clinical pregnancies presented significant better results using the Fertile®Chip-ZyMōt, the increase in the fecundation rate was not significant. More studies analysing a larger number of ICSI cycles are needed to confirm these findings.

Wider implications of the findings: The use of the Fertile®Chip-ZyMōt in ICSI cycles to treat high values of DSB in sperm increase biochemical and clinical pregnancy rates. These increases are even more important when oocytes are from a donor.