# Migration–Gravity Sedimentation: An Effective Approach for Reducing Sperm DNA Fragmentation With Comparable Intracytoplasmic Sperm Injection Outcomes Compared to Density Gradient Centrifugation

## TL;DR

This study compares two sperm preparation methods for ICSI and finds that migration–gravity sedimentation reduces DNA fragmentation without compromising outcomes.

## Contribution

MGS is introduced as a centrifuge-free, low-cost alternative to DGC with comparable ICSI outcomes and reduced DNA fragmentation.

## Key findings

- MGS significantly reduced sperm DNA fragmentation compared to raw semen and DGC.
- Fertilization and clinical outcomes, including blastocyst formation and pregnancy rates, were comparable between MGS and DGC.
- MGS improved certain motility parameters like straightness and linearity but reduced others like curvilinear velocity.

## Abstract

To compare the efficacy of migration–gravity sedimentation (MGS) and density gradient centrifugation (DGC) for sperm preparation in intracytoplasmic sperm injection (ICSI) cycles, focusing on sperm DNA fragmentation (SDF) and ICSI outcomes.

In this prospective study, 32 patients who underwent ICSI using sibling oocytes were enrolled. Half of the oocytes were fertilized with DGC‐prepared sperm and the other half with MGS‐prepared sperm. Semen parameters were assessed using computer‐assisted sperm analysis (CASA), and SDF levels were measured using the terminal deoxynucleotidyl transferase dUTP nick end labeling assay before and after sperm preparation. Fertilization, blastocyst development, and clinical pregnancy rates were compared between the two groups.

MGS significantly reduced SDF levels compared to raw semen and DGC. CASA demonstrated enhanced motility, straightness, and linearity with MGS, although curvilinear velocity, average path velocity, and amplitude of lateral head displacement were lower. Fertilization and clinical outcomes, including blastocyst formation and pregnancy rates, were comparable between the groups.

MGS is a simple, centrifuge‐free, and low‐cost sperm preparation technique that effectively reduces sperm DNA fragmentation and achieves ICSI outcomes similar to those of DGC. These findings indicate that MGS may be a viable alternative to assisted reproductive technology, specifically in patients without male‐factor infertility.

This study was registered in the University Hospital Medical Information Network (UMIN000043585)