Sperm DNA fragmentation can be produced in one (ssSDF) or both (dsSDF) DNA strands, linked to difficulties in naturally achieving a pregnancy and recurrent miscarriages, respectively. The techniques more frequently used to select sperm require centrifugation, which may induce sperm DNA fragmentation (SDF). The objective of this study was to assess whether the microfluidic-based device FertileChip® (now ZyMot®ICSI) can diminish the proportion of sperm with dsSDF. First, in a blinded split pilot study, the semen of nine patients diagnosed with ≥60% dsSDF, was divided into three aliquots: not processed, processed with FertileChip®, and processed with swim up. The three aliquots were all analyzed using neutral COMET for the detection of dsSDF, resulting in a reduction of 46% (P < 0.001) with FertileChip® (dsSDF: 34.9%) compared with the ejaculate and the swim up (dsSDF: 65%). Thereafter, the FertileChip® was introduced into clinical practice and a cohort of 163 consecutive ICSI cycles of patients diagnosed with ≥60% dsSDF was analyzed. Fertilization rate was 75.41%. Pregnancy rates after the first embryo transfer were 53.2% (biochemical), 37.8% (clinical), 34% (ongoing) and the live birth rate was 28.8%. Cumulative pregnancy rates after one (65.4% of patients), two (27.6% of patients) or three (6.4% of patients) transfers were 66% (biochemical), 56.4% (clinical), 53.4% (ongoing) and the live birth rate was 42%. The selection of spermatozoa using Fertile Chip® significantly diminishes the percentage of dsSDF, compared with either the fresh ejaculate or after swim up. Its applicability in ICSI cycles of patients with high dsSDF resulted in good laboratory and clinical outcomes.

精子 DNA 片段可以在一条 (ssSDF) 或两条 (dsSDF) DNA 链中产生，这分别与自然怀孕和反复流产的困难有关。更常用于选择精子的技术需要离心，这可能会导致精子 DNA 片段化 (SDF)。本研究的目的是评估基于微流体的装置 FertileChip ®（现为 ZyMot ® ICSI）是否可以减少 dsSDF 的精子比例。首先，在一项盲分试验研究中，将 9 名诊断为 ≥60% dsSDF 的患者的精液分成三等份：未处理、使用 FertileChip ®处理, 并用游泳处理。三个等分试样均使用中性 COMET 进行分析以检测 dsSDF，与射精和游泳 (dsSDF: 65%) 相比，使用 FertileChip ® (dsSDF: 34.9%) 减少了 46% ( P < 0.001 ) . 此后，FertileChip ®被引入临床实践，并对诊断为≥60% dsSDF 的患者的 163 个连续 ICSI 周期的队列进行了分析。受精率为75.41%。第一次胚胎移植后的妊娠率为53.2%（生化）、37.8%（临床）、34%（进行中），活产率为28.8%。一次（65.4% 的患者）、两次（27.6% 的患者）或三次（6.4% 的患者）转移后的累积妊娠率分别为 66%（生化）、56.4%（临床）、53.4%（进行中）和活产率为 42%。与新鲜精液或游泳后的精液相比，使用 Fertile Chip ®选择精子显着降低了 dsSDF 的百分比。它在高 dsSDF 患者的 ICSI 周期中的适用性产生了良好的实验室和临床结果。