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Chapter 27 - Optimal Sperm Selection in the ICSI Era

from Section 4 - Laboratory Evaluation and Treatment of Male Infertility

Published online by Cambridge University Press:  06 December 2023

Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
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Summary

The prevalence of azoospermia in the general population is 1% and azoospermic men constitute approximately 10–15% of all infertile men. While the advent of microTESE substantially improved sperm recovery compared to standard biopsy or other techniques, the procedure remains inefficient, costly, and very time consuming, both in retrieval and separation/sorting. Three conventional sperm sorting techniques are commonly used in andrology clinics: density gradient centrifugation, sperm washing, and swim-up, all of which have provided reliable solutions to isolate normal sperm from highly concentrated semen samples. The field of microfluidics is the most rapidly developing field for sperm selection related to the field of ART. It is particularly powerful when considering applications in single-cell or low-cell number analyses. Magnetically activated cell sorting and fluorescence-activated cell sorting are alternative and promising technologies. Further research is needed to optimally identify and isolate sperm to help couples achieve the goal of biologic children.

Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
, pp. 210 - 217
Publisher: Cambridge University Press
Print publication year: 2023

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