Use of high-magnification microscopy for the assessment of sperm recovered after two different sperm processing methods

ObjectiveTo compare the quality of sperm samples obtained after density-gradient centrifugation and swim-up by performing a nuclear structural analysis with high magnification microscopy at ×8,000.DesignProspective and randomized split-sample study.SettingReproductive Medicine Center.Patient(s)Sperm samples from 53 male-partners of couples undergoing infertility treatment.Intervention(s)Samples were analyzed by high magnification microscopy before and after preparation and classified according the level of nuclear vacuolization.Main Outcome Measure(s)Recovery rate, motility rate and percentage of sperm scoring each of 4 grades of vacuolization in fresh and processed sample.Result(s)Both sperm processing methods, swim-up and density gradient centrifugation, allowthe selection of sperm with lower nuclear vacuolization and presumably lower DNA fragmentation than the whole ejaculate.Conclusion(s)Swim-up produces samples with less vacuolization, but the recovery rate is also lower. The choice of processing technique would then depend on whether intrauterine insemination, IVF or ICSI/IMSI is to be performed. A prospective randomized study scoring fertility rates would be necessary to directly access the influence of these methods on the fertility outcome.