Analysis of routine and novel sperm selection methods for the treatment of infertile patients undergoing ICSI procedure

Background: Successful outcome of Assisted Reproductive Techniques (ART) depends on many factors such as sperm preparation methods, embryo quality and factors that may affect implantation. In Intra-cytoplasmic Sperm Injection (ICSI), sperm selection is mainly based on sperm motility and morphology; however, studies have revealed that these parameters cannot guarantee the genomic health. Recently, researchers and scientific have focused on new sperm selection methods based on cellular and molecular properties. Therefore, the aim of this review article was to introduce the routine and novel sperm selection methods, advantages and disadvantages of these methods, and their clinical analysis.

Methods: The papers related to routine and novel sperm selection methods based on function tests and clinical outcomes were retrieved from PubMed and Entrez databases and other ISI-related databases.

Results: Novel sperm selection methods which are based on selection of a single sperm (like IMSI and ability of sperm to bind to zona) are time-consuming and costly. In addition, assessment of DNA fragmentation is difficult for the selected sperm. However, methods that select a population of spermatozoa like Zeta are less time-consuming and suitable for assessment of sperm chromatin integrity.

Conclusion: In clinical applications, simultaneous use of traditional and novel approaches may improve ICSI outcome. However, further studies are needed to select an appropriate sperm selection procedure.