A (virtual) banner year: ASRM 2020
Months into the COVID-19 era, the fertility industry is still adapting to a socially-distanced world. Challenges abound. Patient care has changed. Labs have new concerns about their workforce and staffing. But this year brought another first: the American Society of Reproductive Medicine held an all-virtual meeting. We gathered in chat rooms instead of convention halls. We clicked and we watched. We typed questions and we downloaded posters. And we also learned.
While the ZyMōt™ Fertility team missed seeing smiling faces and doing demonstrations in the exhibition hall, we were thrilled at the amazing amount of great science. For researchers focused on sperm health, it was, well, fertile ground. And for ZyMōt Fertility, it was a banner year for research that explored different aspects of our innovative sperm separation technology. Here’s a roundup of our highlights:
(Please note that the linked abstracts have not yet been published by ASRM and require logging in to view.)
The importance of DNA integrity
Two presentations (posters) by Keating and colleagues evaluated sperm-specific DNA damage. Their research specifically honed in on double-stranded DNA breaks in sperm – major factors in chromosomal abnormalities, embryo aneuploidy and pregnancy loss. This work reminds us of the challenges that male factor patients can face, and why it’s essential to do everything we can to improve sample quality by selecting sperm with the lowest levels of DNA fragmentation.
Improving euploidy rates
Anderson and colleagues conducted a prospective cohort study that compared the impact of sperm prepared utilizing density gradient centrifugation (DGC) or sperm separation with the ZyMōt Multi (850µL) device on euploidy and pregnancy outcomes. The D5 euploid rate was significantly higher using ZyMōt compared to DGC; no significant difference was observed for D6 blastocyts. No differences were observed for implantation or ongoing pregnancy rates. Anderson also presented results of a Six Sigma-style evaluation of workflow and showed that ZyMōt saves procedural steps and time.
Beyhan and colleagues conducted a retrospective study that examined preimplantation development following ICSI after two different sperm preparation techniques, ZyMōt and DGC, of presumed normal to moderate male infertility patients. Similar fertilization and blastocyst conversion rates between the cohorts were observed. An increased euploid rate of 63%, compared to 59%, was observed for the ZyMōt device and DGC, respectively. Regression analysis indicated an improvement of 0.44, controlling for other known patient characteristics.
In another retrospective study, Palmerola and colleagues compared ongoing pregnancy rates for two cohorts that used either DGC or ZyMōt preparation. A significant improvement in ongoing pregnancy following single, euploid embryo transfer was observed: 86% with ZyMōt, compared to 71% in the DGC cohort. Fertilization, useable blastocysts and D5 and D6 biopsy rates were similar between the DGC and ZyMōt groups. ZyMōt separation resulted in a trend to higher percentage of D7 biopsies.
An alternative to surgery
Men with high levels of sperm DNA fragmentation face a clinical challenge when they pursue ART. Research from Tavares and associates examined samples from male-factor couples who had experienced pregnancy failure. In a subsequent cycle, these patients selected either testicular biopsy or sperm preparation with the ZyMōt Multi (850µL) device. ZyMōt-prepared samples improved outcomes: the ongoing pregnancy rate improved to 92%, from 75% with DGC methods.
Improving outcomes for challenging patients
In an update to her 2019 publication, Parrella and colleagues presented research on male-factor patients with histories of ART failure and asked the question: Is microfluidic sperm separation able to select sperm with higher chromatin integrity, assessing both total sperm chromatin fragmentation with the TUNEL assay and double-stranded breaks with the COMET assay?
This research focused on three populations of patients who had a history of poor ART outcomes with high sperm chromatin fragmentation (SCF) (>=22%). Here, we will describe the two of three sets of clinical experiments. The first set of patients underwent fresh embryo transfer (FET) after processing with DGC. Initially, this group saw low levels of clinical pregnancy and high levels of loss. These patients then had their semen specimens processed with ZyMōt in a subsequent ICSI cycle, yielding significantly higher implantation rates, clinical/ongoing pregnancy rates, and decreased pregnancy loss.
The third set of experiments, in addition to high SCF, also had a history of high embryo aneuploidy rates. Patients underwent PGT-A and frozen embryo transfer, after sperm processing with DGC or ZyMōt. Euploidy rates were significantly higher with ZyMōt compared to DGC processing. Implantation rates, clinical pregnancy rates, ongoing/delivered rates (there were none with DGC) were all significantly higher with ZyMōt compared to DGC processing with greater pregnancy loss, respectively.
From improving workflow to delivering higher pregnancy rates, we’re very pleased to highlight the wide range of positive research presented at ASRM 2020. And we’re excited about the implications for patient care. When providers use ZyMōt, they’re reducing risk, delivering the highest quality samples for their patients and helping to improve the odds of success. At a time when health and safety is on all of our minds, every improvement helps.