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* To whom correspondence should be addressed. E-mail: uwe.paasch{at}medizin.uni-leipzig.de.
Assisted reproductive techniques (ART) have become the treatment of choice in many cases of infertility; however the current success rates of these procedures remain suboptimal. Programmed cell death (apoptosis) most likely contributes to failed ART and to the decrease in sperm quality after cryopreservation. There is likelihood that some sperm selected for ART will display features of apoptosis despite their normal appearance, which may be partially responsible for the low fertilization and implantation rates seen with ART. One of the features of apoptosis is the externalization of phosphatidylserine (PS) residues, which are normally present on the inner leaflet of the sperm plasma membrane. Colloidal super-paramagnetic microbeads (~50 nm in diameter) conjugated with annexin-V bind to PS are used to separate dead and apoptotic spermatozoa by magnetic cell sorting (MACS). Cells with externalized PS will bind to these microbeads, while non-apoptotic cells with intact membranes do not bind and could be used during ART. We have conducted a series of experiments to investigate if the MACS technology could be used to improve ART outcomes. Our results clearly indicate that integrating MACS as a part of sperm preparation techniques will improve semen quality and cryosurvival rates by eliminating apoptotic sperm. Non-apoptotic spermatozoa prepared by MACS display higher quality in terms of routine sperm parameters and apoptosis markers. The higher sperm quality is represented by an increased oocyte penetration potential and cryosurvival rates. Thus, the selection of non-apoptotic spermatozoa by MACS should be considered to enhance ART success rates.
Key words: Cryopreservation
Infertility
Annexin V
Apoptosis
Human
MACS
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