#89 : Higher Euploidy Rate in Embryos Generated by ICSI Using Sperm Obtained After Microfluidics Sperm Sorting (MFSS). A Randomised Controlled Trial

Background and Aims: MFSS is a state-of-the-art technology that has the ability to sort a subpopulation of sperm cells with lower DNA fragmentation index (DFI), higher motility and higher normal forms without the need for centrifugation. Methods: A randomised controlled trial that included 925 couples that were planned for ICSI with day 5/6 biopsy, PGT-A with Next Generation Sequencing (NGS) and blastocyst vitrification. The embryo transfer was planned for future cycles. The inclusion criteria for women were age (18–45), BMI (18–30), AMH level more than 1.1 ng/ml, regular menstrual cycle and normal uterine ultrasound. Whereas the inclusion criteria for men were age (18–50), fresh semen sample with count more than 10 million/ml and total motility more than 30%. Semen samples were randomly assigned with 1:1 ratio to either preparation by routine density gradient (DG) or (MFSS). The primary outcome of the study is PGT-A aneuploidy results. The secondary outcome is the fertilisation rate, and blastocyst development rate. Results: The study was performed between January 2020 and July 2021. 463 semen samples were prepared with density gradient and 462 semen samples were sorted with microfluidic sperm sorting. All of the prepared semen samples were used for ICSI. The euploid embryo rate for the embryos resulted from density gradient preparation was 53.1% versus 59.3% for the embryos resulted from microfluidics sperm sorting (p=0.0034). The fertilisation rate was 77.9% for density gradient group versus 78.3% microfluidics group (p=0.063) and blastocyst rate was 51.6% for the density gradient group versus 59.2% for the microfluidics group (p=0.058). Conclusion: Semen samples prepared with MFSS for ICSI generated higher euploidy embryos following PGT-A with NGS.