Using Magnetic Fields to Select Healthy Sperm: MACS (Magnetic Activated Cell Sorting)

It is well known that having the best possible sperm quality is important to the success of assisted reproduction techniques. To achieve this, the lab has to improve sperm quality based on its motility and morphology, selecting the sperm that is considered to be the best.

However in every ejaculate sperm with abnormal membranes are found, which are programmed to “die”. This process is called apoptosis, or programmed cell death.   Approximately 20% of sperm in subfertile patients are  thought to be in the process of “celular death”.

From very early stages, these sperm show certain markers in their membranes that have been identified. This has allowed a sperm selection technique called MACS (magnetic-activated cell sorting) to be designed. It uses the magnetic microparticles bound to a protein called annexin V that then bind to the markers, phosphatidylserine, that are found in the external part of the sperm membranes that are set for cellular death. Then they are exposed to a magnetic field and are trapped, allowing the best sperm to pass through.

Preliminary studies published have shown that using this technique fragmentation is reduced about 15-20%, vitality increases 10-15%, and motility and morphology improves as well.  This improvement in sperm quality seems to have a positive effect on fertilization rates and embryo quality, especially in patients with severe male factor.

The use of this technique was approved for human use just a few months ago. Instituto Bernabeu tested its use beforehand, and has established two main uses in our patients who could benefit from its results:

• Men with a high degree of DNA fragmentation in sperm (elevated TUNEL): until now the only treatment these men could only count on was antioxidant therapy or testicular sperm retrieval.
• Patients with  in Vitro fertilization failure.

Dra Ana Mª Fabregat, pharmacist at Instituto Bernabeu.

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