Comparison between sperm sorting techniques effect on dna fragmentation and aneuploidy: a systematic review and network meta-analysis
,1 Fariba pashazadeh
,2 Fereshteh ansari
,3 Zahra bahmanpour
,4 Ebrahim sakhinia
,5 Mehdi yousefi
1. Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Ira
2. Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
3. Research Center for Evidence-Based Medicine, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
4. Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
5. Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
6. Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
Assisted reproduction techniques (art) are used worldwide to treat infertile couples and in recent years multiple adjustments have improved the outcome of these techniques. sperm sorting techniques are used to choose the best sperm cell for art procedure. magnetic activated cell sorting (macs), density gradient centrifugation (dgc) and swim up (su) are most prevalent used sperm sorting techniques. dna fragmentation and aneuploidy are two damaging factors in art success and many studies try to find out effect of mentioned sperm separation techniques on dna fragmentation and aneuploidy. in current study we have conducted a systematic review and meta-analysis on previous studies to find out which technique can choose sperm cell with lower dna fragmentation and aneuploidy rate.
Pubmed, embase, proquest, cochrane, clinicaltrail.gov, irct.ir and google scholar was searched which after appraisal by two independent reviewers, twenty one studies included for meta-analysis and six studies narratively discussed. network meta-analysis performed with r software and netmeta package and direct and indirect evidence combined together. surface under the cumulative ranking curve (sucra) used to rank sperm separation techniques which can choose sperm with lower dna fragmentation.
Our results indicated that combination of macs and dgc is best sperm sorting technique to choose sperm cell with lower dna fragmentation. also sperm sorting techniques can effectively reduce aneuploidy in sperm cells.
Macs is novel technique which can choose sperm cells with higher quality for art procedure. dna fragmentation and aneuploidy are damaging biomarkers and our meta-analysis show macs and dgc can effectively reduce dna fragmentation and aneuploidy. in order to reach more accurate results further studies with higher sample number is still required. also, studies try to evaluate dna fragmentation and aneuploidy, need to use rct principles in order to reach more precise results.
Macs; dgc; su; sperm; fecundity