This retrospective study aims to compare laboratory and clinical outcomes of a microfluidic sperm sorting device (ZyMōt) versus a standard density gradient centrifugation (DGC) technique in ICSI cycles using autologous or donor oocytes. A total of 1,091 cycles utilizing ZyMōt and 1,176 cycles employing DGC method were included to investigate fertilization rates, blastocyst developmental rates, embryo euploidy, clinical pregnancy/live birth rates (CPR/LBR) after single embryo transfer. The ZyMōt group yielded lower DNA fragmentation and higher motility in spermatozoa compared to DGC method. Fertilization was increased (81.0% vs.78.7%; P =0.003), and the proportion of day 5 blastocysts was significantly greater using ZyMōt than the DGC method (25.6 % vs. 18.3.1%; P <0.001). The hierarchical multivariate regression models revealed that ZyMōt sperm processing contributed significantly to increased blastulation rates than the DGC method ß = 0.11, P<0.001), after adjusting for female age, male age, and infertility diagnosis. Sperm processed by ZyMōt did not enhance blastocyst euploidy rates in all stratified ages (20-40 years old). However, the cumulative CPR per retrieval using euploid embryos were noticeably higher in ZyMōt versus DGC cohorts in both oocyte donor (82.0% and 59.6%; P= 0.0042) and non-donor (73.6% and 64.5%; P = 0.0152) groups. Similarly, LBR in ZyMōt were improved significantly in both donor and non-donor groups (68.0% versus 49.7%; P= 0.0252, and 62.6% versus 52.3%; P = 0.0099, respectively). Our findings demonstrate that ZyMōt offers several advantages over the conventional DGC approach, resulting in enhanced fertilization rates, significantly increased blastocyst developmental potential and improved clinical outcomes.
Bałakier et al. (Mon,) studied this question.