This systematic review examined advanced sperm selection techniques for women undergoing IVF or ICSI. The analysis pooled data from five randomized trials involving 3,752 women. The main focus was on live birth and miscarriage rates.
For one technique, HA-ICSI, the review found it may slightly decrease the chance of miscarriage per woman compared to standard ICSI. The evidence for live birth with HA-ICSI showed no clear difference or a slight increase. For other techniques like SpermSlow, zeta potential selection, and microfluidic sorting, the evidence was very uncertain regarding live birth.
The review noted limitations, including potential performance and attrition bias, and very low to moderate certainty of the evidence. No safety concerns were reported in the included studies, but fetal abnormalities were not adequately reported.
The main reason to be careful is that the evidence is not strong enough to recommend any advanced technique for routine practice. Readers should understand that while one method shows promise for reducing miscarriage, more high-quality studies are needed.