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A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques
Mkhize, N. M. 2025. A Retrospective Study on the Clinical and Laboratory Outcomes of the Microfluidic Spermatozoa Sorting Technique Compared to the Swim-Up and Density Gradient Centrifugation Techniques. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://s...
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Stellenbosch : Stellenbosch University
2025
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| author | Mkhize, Ntando Mamayi |
| author2 | Matsaseng, Thabo |
| author_browse | Matsaseng, Thabo Mkhize, Ntando Mamayi |
| author_facet | Matsaseng, Thabo Mkhize, Ntando Mamayi |
| author_sort | Mkhize, Ntando Mamayi |
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| description | Mkhize, N. M. 2025. A Retrospective Study on the Clinical and Laboratory Outcomes of the Microfluidic Spermatozoa Sorting Technique Compared to the Swim-Up and Density Gradient Centrifugation Techniques. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/195df1cf-dbb3-41c4-8bb0-8b2fc6fff807 |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/132594 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:41:24.431Z |
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| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
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| spelling | oai:scholar.sun.ac.za:10019.1/132594 A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques Mkhize, Ntando Mamayi Matsaseng, Thabo Erasmus, Evelyn Burger, Riana Fernhout, Micke Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. Obstetrics and Gynaecology. Infertility -- Treatment Spermatozoa -- Motility -- Disorders Microfluidics Reproductive technology UCTD Mkhize, N. M. 2025. A Retrospective Study on the Clinical and Laboratory Outcomes of the Microfluidic Spermatozoa Sorting Technique Compared to the Swim-Up and Density Gradient Centrifugation Techniques. Unpublished masters thesis. Stellenbosch: Stellenbosch University [online]. Available: https://scholar.sun.ac.za/items/195df1cf-dbb3-41c4-8bb0-8b2fc6fff807 Thesis (MSc)--Stellenbosch University, 2025. ENGLISH ABSTRACT: Background: Approximately 30% of infertility cases are attributed solely to male factors, with an additional 20% of infertility cases involving a combination of male and female factors. This results in 50% of infertility cases where male infertility plays a role (Mazzilli et al., 2023). This has then urged scientists and clinicians to improve spermatozoa preparation techniques that focus on the selection and enrichment of motile and functionally competent spermatozoa from the ejaculate for insemination (World Health Organisation, 2021). Advancements in andrological research have focused on gaining a deeper understanding of spermatozoa physiology to develop more sophisticated techniques to separate functional spermatozoa from those that are immotile, have poor morphology or are not capable of fertilising oocytes (Henkel, 2012; Brahmbhatt, 2021). In the early years of ART, spermatozoa preparation strategies were mainly focused on obtaining motile spermatozoa however, the focus has now shifted towards obtaining viable and functional spermatozoa (Agarwal et al., 2020). Each semen preparation technique employed in clinical practice presents a unique set of advantages and disadvantages, which significantly influences its effectiveness and applicability in different clinical scenarios. These variations contribute to the ongoing challenge of identifying the optimal technique that maximises reproductive outcomes for infertility patients. As such, the search for the ideal semen preparation technique continues to be an area of active research and clinical refinement. This study, therefore, seeks to compare and analyse the various semen preparation techniques currently utilised in clinical practice, with a particular focus on evaluating the potential of the emerging microfluidic spermatozoa sorting technique (MFSS). Aim: To retrospectively compare the laboratory and clinical outcomes between three semen preparation techniques that are utilised in ART. Primary objectives: To retrospectively evaluate the percentage recovery in semen parameters (concentration and motility) before and after the utilisation of the MFSS technique compared to the swim-up (SU) and density gradient centrifugation (DGC) techniques. Secondary objectives: To retrospectively analyse and compare the fertilisation rate (%), percentage of good quality embryos (≥2BB) produced for transfer and the clinical pregnancy rate (%) of each semen preparation technique. Materials and Methods: This study was retrospectively conducted on the data obtained from medical and laboratory records of 213 patients between 2021-2023 at Drs Aevitas Fertility Clinic, South Africa. Data was categorised and filtered based on predetermined inclusion and exclusion criteria. Data was submitted for statistical analysis with a statistical significance of p ≤ 0.05. Results: For fertilisation rate: The DGC technique was not significantly different compared to the SU technique (66% vs 66%). The DGC technique was not significantly different compared to the MFSS technique (73% vs 66%). The MFSS technique was significantly higher to the SU technique (73% vs 66%). For the good quality embryo rate: The DGC technique was not significantly different compared to the SU technique (41% vs 41%). The MFSS technique was significantly higher compared to the DGC technique (41% vs 65%) and the MFSS technique was significantly higher compared to the SU technique (65% vs 41%). For the clinical pregnancy rate: The DGC technique was not significantly different to the SU technique (36% vs 28%). The DGC was not significantly different compared to the MFSS technique (36% vs 58%). The MFSS technique was significantly higher to the SU technique (58% vs 28%). For the mean concentration decrease: The DGC technique was not significantly different to the SU technique (54% vs 48%). The DGC technique was not significantly different to the MFSS technique (54% vs 65%). The SU technique had a significantly lower mean decrease in spermatozoa concentration compared to the MFSS technique (48% vs 65%). For the mean motility increase: The MFSS technique was not significantly different to the SU technique (97% vs 84%). The DGC technique had a significantly lower mean increase in motility compared to the SU technique (61% vs 84%). The DGC technique had a significantly lower mean increase in motility compared to the MFSS technique (61% vs 97%). Conclusion: The current study found that the MFSS group resulted in lower spermatozoa concentrations and higher motility of spermatozoa compared to both the swim-up group and DGC group post semen preparation. The MFSS group did not result in a greater fertilisation rate when compared to the DGC group, however did perform significantly higher compared to the SU group. The MFSS group resulted in a greater clinical pregnancy rate compared to the SU group, but not the DGC group. However, a higher trend was observed in the clinical pregnancy rate of the MFSS group compared to the DGC group. Lastly, the MFSS group resulted in a higher percentage of good quality embryos (≥ 2BB) compared to the conventional SU and DGC techniques. Although microfluidic spermatozoa sorting techniques may not drastically alter reproductive outcomes at this stage, they hold promise for enhancing the quality of selected spermatozoa, particularly in patients with high DNA fragmentation (Pardiñas Garcia et al., 2022). AFRIKAANSE OPSOMMING: Agtergrond: Ongeveer 30% van onvrugbaarheidgevalle word uitsluitlik aan manlike faktore toegeskryf, met 'n bykomende 20% van onvrugbaarheidgevalle wat 'n kombinasie van manlike en vroulike faktore insluit, dus dra manlike onvrugbaarheid tot 50% van gevalle (Mazzilli et al., 2023). Dit het wetenskaplikes en fertiliteitspesialiste aangespoor om semen voorbereidingstegnieke te verbeter wat fokus op die seleksie en verkryging van motiele en funksionele spermatosoa uit die ejakulaat vir inseminasie (Wêreldgesondheidsorganisasie, 2021). Vooruitgang in andrologiese navorsing het gefokus op die verkryging van 'n dieper begrip van spermatosoon fisiologie om meer gesofistikeerde tegnieke te ontwikkel om funksionele spermatosoa te skei van dié wat immotiel is, swak morfologie het of nie in staat is om oösiete te bevrug nie (Henkel, 2012; Brahmbhatt, 2021). In die vroeë jare van ART was spermatosoa voorbereidingstrategieë hoofsaaklik gefokus op die verkryging van beweeglike spermatosoa, maar die fokus het nou verskuif na die verkryging van lewensvatbare en funksionele spermatosoa (Agarwal et al., 2020). Elke semenvoorbereidingstegniek wat in die kliniese praktyk gebruik word, bied 'n unieke stel voordele en nadele, wat die doeltreffendheid en toepaslikheid daarvan in verskillende kliniese scenario's aansienlik beïnvloed. Hierdie variasies dra by tot die voortdurende uitdaging om die optimale tegniek te identifiseer wat reproduktiewe uitkomste vir onvrugbaarheidspasiënte verbeter. As sodanig bly die soeke na die ideale semenvoorbereidingstegniek 'n gebied van aktiewe navorsing en kliniese verfyning. Hierdie studie poog dus om die verskillende semenvoorbereidingstegnieke wat tans in die kliniese praktyk gebruik word te vergelyk en te ontleed, met 'n besondere fokus op die evaluering van die potensiaal van die opkomende mikrofluïdiese spermatozoa skeidingstegniek (MFSS). Doel: Om retrospektief die laboratorium en kliniese uitkomste te vergelyk tussen drie semenvoorbereidingstegnieke wat in voortplantingstegnologie (VRB) gebruik word. Primêre doelstellings: Was om die persentasie herstel in semenparameters (konsentrasie en motiliteit) voor en na die gebruik van die MFSS-tegniek in vergelyking met die SU- en DGC-tegnieke retrospektief te evalueer. Persentasie van bevrugting (%), persentasie van goeie kwaliteit embrio's (≥2BB) geproduseer vir terugplasing en die kliniese swangerskapsuitkoms (%) van elke semenvoorbereidingstegniek retrospektief te ontleed en te vergelyk. https://scholar.sun.ac.za vi Sekondêre doelstellings: Was om bestaande literatuur te hersien wat die idee ondersteun of teenstaan dat die opkomende MFSS-tegniek verbetering in reproduktiewe uitkomste vir onvrugbaarheidspasiënte bied, in vergelyking met tradisionele semenvoorbereidingstegnieke. Materiale en Metodes: Hierdie studie is retrospektief uitgevoer op die data verkry uit mediese en laboratoriumrekords van 213 pasiënte tussen 2021-2023 by Drs Aevitas Fertility Clinic, Suid-Afrika. Data is gekategoriseer en geanaliseer op grond van voorafbepaalde insluiting- en uitsluitingskriteria. Data is ingedien vir statistiese analise met 'n statistiese betekenisvolle waarde van p ≤ 0.05. Resultate: Vir persentasie van bevrugting: Die DGC-tegniek was nie betekenisvol verskillend in vergelyking met die SU-tegniek nie (66% vs 66%). Die DGC-tegniek was nie betekenisvol in vergelyking met die MFSS-tegniek nie (73% vs 66%), maar die MFSS-tegniek was aansienlik hoër as die SU-tegniek (73% vs 66%). Vir die presentasie van goeie kwaliteit embrios: Die DGC-tegniek was nie betekenisvol verskillend in vergelyking met die SU-tegniek nie (41% vs 41%). Die MFSS-tegniek was aansienlik hoër in vergelyking met die DGC-tegniek (41% vs 65%) en die MFSS-tegniek was aansienlik hoër in vergelyking met die SU-tegniek (65% vs 41%). Vir die kliniese swangerskapsuitkoms: Die DGC-tegniek het nie betekenisvol verskil van die SUtegniek nie (36% vs 28%). Die DGC was nie betekenisvol anders in vergelyking met die MFSS-tegniek nie (36% vs 58%), maar die MFSS-tegniek was aansienlik hoër as die SU-tegniek (58% vs 28%). Vir die gemiddelde konsentrasie-afname: Die DGC-tegniek het nie betekenisvol verskil van die SUtegniek nie (54% vs 48%). Die DGC-tegniek het nie betekenisvol verskil van die MFSS-tegniek nie (54% vs 65%). Die SU-tegniek het 'n aansienlik laer gemiddelde afname in spermatosoa-konsentrasie gehad, in vergelyking met die MFSS-tegniek (48% vs 65%). Vir die gemiddelde toename in motiliteit: Die MFSS-tegniek het nie betekenisvol verskil van die SUtegniek nie (97% vs 84%). Die DGC-tegniek het 'n aansienlik laer gemiddelde toename in beweeglikheid gehad in vergelyking met die SU-tegniek (61% vs 84%). Die DGC-tegniek het 'n aansienlik laer gemiddelde toename in motiliteit gehad, in vergelyking met die MFSS-tegniek (61% vs 97%). Gevolgtrekking: Die huidige studie het bevind dat die MFSS-groep gelei het tot laer spermatosoa konsentrasies en hoër beweeglikheid van spermatosoa, in vergelyking met beide die opswem groep en DGC groep ná semen voorbereiding. Die MFSS-groep het nie 'n groter persentasie van bevrugting tot gevolg gehad, in vergelyking met die DGC-groep nie, maar het wel aansienlik hoër presteer in https://scholar.sun.ac.za vii vergelyking met die SU-groep. Die MFSS-groep het 'n groter kliniese swangerskapsuitkoms tot gevolg gehad in vergelyking met die SU-groep, maar nie die DGC-groep nie. 'n Toename is egter waargeneem in die kliniese swangerskap persentasie uitkoms van die MFSS-groep, in vergelyking met die DGCgroep. Laastens het die MFSS-groep 'n hoër persentasie van goeie kwaliteit embrio's (≥ 2BB) tot gevolg gehad, in vergelyking met die konvensionele SU en DGC tegnieke. Alhoewel mikrofluïdiese tegnieke nie op hierdie stadium die voortplantingsuitkomste drasties kan verander nie, hou dit belofte in vir die verbetering van die kwaliteit van geselekteerde spermatosoa, veral by pasiënte met hoë DNAfragmentasie (Pardiñas Garcia et al., 2022). Masters 2025-06-11T11:53:06Z 2025-06-11T11:53:06Z 2025-03 Thesis https://scholar.sun.ac.za/handle/10019.1/132594 en Stellenbosch University 90 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Infertility -- Treatment Spermatozoa -- Motility -- Disorders Microfluidics Reproductive technology UCTD Mkhize, Ntando Mamayi A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques |
| title | A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques |
| title_full | A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques |
| title_fullStr | A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques |
| title_full_unstemmed | A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques |
| title_short | A retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim-up and density gradient centrifugation techniques |
| title_sort | retrospective study on the clinical and laboratory outcomes of the microfluidic spermatozoa sorting technique compared to the swim up and density gradient centrifugation techniques |
| topic | Infertility -- Treatment Spermatozoa -- Motility -- Disorders Microfluidics Reproductive technology UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/132594 |
| work_keys_str_mv | AT mkhizentandomamayi aretrospectivestudyontheclinicalandlaboratoryoutcomesofthemicrofluidicspermatozoasortingtechniquecomparedtotheswimupanddensitygradientcentrifugationtechniques AT mkhizentandomamayi retrospectivestudyontheclinicalandlaboratoryoutcomesofthemicrofluidicspermatozoasortingtechniquecomparedtotheswimupanddensitygradientcentrifugationtechniques |