Sperm Selection by Either PICSI or MACS in Cases With Abnormal Sperm DNA Fragmentation Index for ICSI

NCT ID: NCT03398317

Last Updated: 2020-07-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

396 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-01-01

Study Completion Date

2019-03-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

On the day of ICSI, choosing the best sperm by either PICSI or magnetic activated cell sorting (MACS) in cases with abnormal DNA is not fully investigated. This study helps in solving this problem by using two known techniques to achieve that purpose.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Sperm DNA fragmentation has shown a negative correlation with fertilization rate, embryo quality, and implantation rate. And a positive correlation with miscarriage rate in the 1st trimester.

Sperm selection methods like PICSI and MACS have been developed for selecting a healthy mature non apoptotic sperm with healthy membrane for Oocyte injection so as to obtain best embryo quality and achieve higher ongoing pregnancy rates.

A sperm selection technique based on sperm membrane binding to hyaluronic acid (PICSI Dish), the main substrate of the oocyte zonapellucida, could improve the likelihood of obtaining better sperm for ICSI with non fragmented DNA. Another sperm selection technique based on Magnetic activated cell sorting (MACS) that depends on the binding of protein Annexin V to phosphatidylserine which is a marker for apoptosis, giving a resulting (eluted) spermatozoa without DNA fragmentation.

In order to determine which sperm selection technique is better for dealing with DNA fragmentation patients we need to study both techniques on two different groups of patients

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Sperm DNA Fragmentation

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

PICSI

Semen processing is done by double layer density gradient method followed by adding Sperm to the dot of hyaluronan on the PICSI dish, within minutes the bound sperm are attached by their acrosome to the surface of the dot. Selecting an individual bound sperm with enhanced genetic and developmental integrity ensures that the sperm selected is the optimal sperm from the sample for oocyte injection

Group Type EXPERIMENTAL

PICSI

Intervention Type OTHER

sperm selection using PICSI dish for selecting sperm with lower DNA fragmentation index

MACS

Semen processing is done by double layer density gradient method. The resulted pellet is labeled with annexin V microbeads followed by separation on MACS Column, the eluted fraction contains non apoptotic sperm suitable for Oocyte injection.

Group Type ACTIVE_COMPARATOR

MACS

Intervention Type OTHER

sperm selection using MACS for selecting sperm with lower DNA fragmentation index

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

PICSI

sperm selection using PICSI dish for selecting sperm with lower DNA fragmentation index

Intervention Type OTHER

MACS

sperm selection using MACS for selecting sperm with lower DNA fragmentation index

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Males diagnosed of abnormal DNA fragmentation index ( \> 19%).
* Males with mild to moderate OTA (oligoteratoasthenozoospermia).
* Male aged 18-60 years.
* Female aged 18-40 years.
* Normo responder ( \> 5 mature oocytes)
* Male will have to refrain from ejaculation no less than 1 day but no greater than 3 days prior semen specimen production on day of oocyte retrieval

Exclusion Criteria

Males with normalDNA fragmentation index (\<19%)at the initial assessment.

* Leukocytospermia
* Presence of varicocele.
* Known genetic abnormality
* Use of sperm donation or cryopreserved sperm
* Use of Oocyte donation
* Use of gestational carrier
* Presence of any of the endometrial factors that affect embryo implantation such as hydrosalpings, adenomyosis or previous uterine infection
* Any contradictions to undergoing in vitro fertilization or gonadotropin stimulation
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

The Cleveland Clinic

OTHER

Sponsor Role collaborator

University of the Western Cape

OTHER

Sponsor Role collaborator

Ganin Fertility Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Eman Hasanen

Clinical Embryologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Hosam Zaki, MSc, FRCOG

Role: STUDY_CHAIR

Ganin Fertility Center, Cairo, Egypt

Eman Hasanen, BSc

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt

Khaled El Qusi, BSc

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt

Abd El Ghafar Hussin, BSc

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt

Salma El Tanbouly, BSc

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt

Ashok Agarwal, PhD

Role: STUDY_DIRECTOR

American Center of Reproductive Medicine, Cleveland Clinic

Ralph Henkel, PhD

Role: PRINCIPAL_INVESTIGATOR

University of the Western Cape

Hanaa Alkhader

Role: PRINCIPAL_INVESTIGATOR

Ganin Fertility Center, Cairo, Egypt

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Ganin Fertility Center

Cairo, , Egypt

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Egypt

References

Explore related publications, articles, or registry entries linked to this study.

Benchaib M, Braun V, Lornage J, Hadj S, Salle B, Lejeune H, Guerin JF. Sperm DNA fragmentation decreases the pregnancy rate in an assisted reproductive technique. Hum Reprod. 2003 May;18(5):1023-8. doi: 10.1093/humrep/deg228.

Reference Type BACKGROUND
PMID: 12721180 (View on PubMed)

Baldi and Muratori (2013) Genitic Damage in Human Spermatozoa. USA, NY : Springer Science & Business Media.

Reference Type BACKGROUND

Hasanen E, Elqusi K, ElTanbouly S, Hussin AE, AlKhadr H, Zaki H, Henkel R, Agarwal A. PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial. J Assist Reprod Genet. 2020 Oct;37(10):2605-2613. doi: 10.1007/s10815-020-01913-4. Epub 2020 Aug 8.

Reference Type DERIVED
PMID: 32772268 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

GFC - 002

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Sex Selection of Human Spermatozoa
NCT05500573 RECRUITING NA