Article Clinical assisted reproductive technology|Articles in Press

Semen processing using MACS before ICSI deemed safe towards obstetric and perinatal outcomes of cycles using either donated or autologous oocytes: a retrospective multicentre study.

Published:February 01, 2023DOI:


      Research question

      Is magnetic-activated cell sorting (MACS) a safe semen sample processing technique for the newborns and mothers when used for semen processing prior to ICSI cycles?


      Retrospective multicentre cohort study involving patients undergoing ICSI cycles with either donor or their own oocytes from January 2008 to February 2020 divided into two groups: those who underwent standard semen preparation (reference) and those who had an added MACS procedure (MACS). 25,356 deliveries were assessed in the case of cycles using donor oocytes and 19,703 deliveries from cycles using autologous oocytes. Of those, 20,439 and 15,917 respectively were singleton deliveries. Obstetric and perinatal outcomes were retrospectively assessed. All means, rates and incidences were computed per live newborn in each study group.


      There were no significant differences between the main obstetric and perinatal morbidities threatening the mothers’ and newborns’ wellbeing between groups using neither donated or autologous oocytes. There was a significant increase in the incidence of gestational anaemia in both subpopulations. However, this incidence was within the estimated prevalence of gestational anaemia in the general population. There was statistically significant decrease in preterm and very preterm birth rates in the MACS group in cycles using donor oocytes.


      The use of MACS during semen preparation before ICSI using either donor or the patient's own oocytes appears to be safe for the mothers’ and newborns’ wellbeing during pregnancy and birth. Nevertheless, close follow up of these parameters in the future is advised, mainly concerning anaemia, in order to detect even smaller effect size.

      Study funding/competing interest(s)



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      María Gil Juliá is a predoctoral researcher of the Andrology and Male Infertility group at IVI Foundation. She obtained a MSc in Biotechnology of Human Assisted Reproduction by the Universidad de Valencia in 2020 and a MRes in Biomedical Research by Imperial College London in 2018.