Comparison of zeta potential and physiological intracytoplasmic sperm injection in obtaining sperms with a lower DNA fragmentation index: A cross-sectional study


Background: The sperm DNA fragmentation index (DFI) is one of the men’s reproductive health criteria that affects assisted reproductive technique outcomes. Efforts in obtaining high-quality mature sperms seem to be necessary. Advanced sperm selection techniques (including physiological intracytoplasmic sperm injection [PICSI], zeta potential, microfluidic, etc.) have gained popularity in this regard.

Objective: The study aimed to compare the efficacy of zeta potential and PICSI sperm selection in obtaining sperms with better DNA integrity.

Materials and Methods: In this cross-sectional study, 48 couples were enrolled where the male partner had increased sperm DFI in his ejaculated sample and the female was in normal reproductive health. For each male partner, the semen sample was processed with zeta potential and PICSI techniques, then the sperm DFI of neat semen was compared to zeta and PICSI samples by the sperm chromatin dispersion test.

Results: Data showed that both the zeta potential and PICSI technique decreased sperm DFI in comparison with the neat semen sample (p < 0.001 for both). In addition, there was a statistically significant difference in sperm DFI between the PICSI and zeta potential samples (p < 0.01).

Conclusion: The current study showed that both zeta potential and PICSI could result in sperm with a lower DFI. However, PICSI seems to be superior to zeta potential in this regard.

Key words: PICSI, ZETA potential, Hyaluronic acid, DNA integrity.

[1] Vahidi S, Moein MR, Yazdinejad F, Ghasemi-Esmailabad S, Narimani N. Iranian temporal changes in semen quality during the past 22 years: A report from an infertility center. Int J Reprod Biomed 2020; 18: 1059–1064.

[2] Agarwal A, Allamaneni SSR. Sperm DNA damage assessment: A test whose time has come. Fertil Steril 2005; 84: 850–853.

[3] Deng C, Li T, Xie Y, Guo Y, Yang QY, Liang X, et al. Sperm DNA fragmentation index influences assisted reproductive technology outcome: A systematic review and meta-analysis combined with a retrospective cohort study. Andrologia 2019; 51: e13263.

[4] Zini A. Are sperm chromatin and DNA defects relevant in the clinic? Syst Biol Reprod Med 2011; 57: 78–85.

[5] Ionov M, Gontarek W, Bryszewska M. Zeta potential technique for analyzing semen quality. MethodsX 2020; 7: 100895.

[6] Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho ChL, Henkel R, et al. Sperm DNA fragmentation: A new guideline for clinicians. World J Mens Health 2020; 38: 412–471.

[7] Vahidi S, Narimani N, Ghanizadeh T, Yazdinejad F, Emami M, Mehravaran K, et al. The short abstinence may have paradoxical effects on sperms with different level of DNA integrity: A prospective study. Urol J 2021; in Press.

[8] Pinto S, Carrageta DF, Alves MG, Rocha A, Agarwal A, Barros A, et al. Sperm selection strategies and their impact on assisted reproductive technology outcomes. Andrologia 2021; 53: e13725.

[9] Parmegiani L, Cognigni GE, Ciampaglia W, Pocognoli P, Marchi F, Filicori M. Efficiency of hyaluronic acid (HA) sperm selection. J Assist Reprod Genet 2010; 27: 13–16.

[10] Erberelli RF, Salgado RM, Pereira DHM, Wolff Ph. Hyaluronan-binding system for sperm selection enhances pregnancy rates in ICSI cycles associated with male factor infertility. JBRA Assist Reprod 2017; 21: 2–6.

[11] Jean M, Mirallie S, Boudineau M, Tatin C, Barriere P. Intracytoplasmic sperm injection with polyvinylpyrrolidone: A potential risk. Fertil Steril 2001; 76: 419–420.

[12] Duarte C, Nunez V, Wong Y, Vivar C, Benites E, Rodriguez U, et al. Impact of the Z potential technique on reducing the sperm DNA fragmentation index, fertilization rate and embryo development. JBRA Assist Reprod 2017; 21: 351– 355.

[13] Ghorbani-Sini R, Izadi T, Tavalaee M, Azadi L, Hajian M, Rahimi Zamani M, et al. Comparison of sperm telomere length between two sperm selection procedures: Density gradient centrifugation and zeta potential. Int J Fertil Steril 2020; 14: 51–56.

[14] Razavi SH, Nasr-Esfahani MH, Deemeh MR, Shayesteh M, Tavalaee M. Evaluation of zeta and HA-binding methods for selection of spermatozoa with normal morphology, protamine content and DNA integrity. Andrologia 2010; 42: 13–19.

[15] Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HWG, Behre HM, et al. World health organization reference values for human semen characteristics. Hum Reprod Update 2009; 16: 231–245.

[16] Nabi A, Khalili MA, Fesahat F, Talebi A, Ghasemi- Esmailabad S. Pentoxifylline increase sperm motility in devitrified spermatozoa from asthenozoospermic patient without damage chromatin and DNA integrity. Cryobiology 2017; 76: 59–64.

[17] Nasr Esfahani MH, Deemeh MR, Tavalaee M, Sekhavati MH, Gourabi H. Zeta sperm selection improves pregnancy rate and alters sex ratio in male factor infertility patients: A double-blind, randomized clinical trial. Int J Fertil Steril 2016; 10: 253–260.

[18] Mokanszki A, Tothne EV, Bodnar B, Tandor Z, Molnar Z, Jakab A, et al. Is sperm hyaluronic acid binding ability predictive for clinical success of intracytoplasmic sperm injection: PICSI vs. ICSI? Syst Biol Reprod Med 2014; 60: 348–354.

[19] Hasanen E, Elqusi K, ElTanbouly S, Hussin AE, AlKhadr H, Zaki H, et al. PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: A prospective randomized trial. J Assist Reprod Genet 2020; 37: 2605–2613.

[20] Kato Y, Nagao Y. Effect of polyvinylpyrrolidone on sperm function and early embryonic development following intracytoplasmic sperm injection in human assisted reproduction. Reprod Med Biol 2012; 11: 165–176.

[21] Ding D, Wang Q, Li X, Chen B, Zou W, Ji D, et al. Effects of different polyvinylpyrrolidone concentrations on intracytoplasmic sperm injection. Zygote 2020; 14: 1–6.

[22] Huszar G, Jakab A, Sakkas D, Ozenci CC, Cayli S, Delpiano E, et al. Fertility testing and ICSI sperm selection by hyaluronic acid binding: Clinical and genetic aspects. Reprod Biomed Online 2007; 14: 650–663.

[23] Parmegiani L, Cognigni GE, Bernardi S, Troilo E, Ciampaglia W, Filicori M. ”Physiologic ICSI”: Hyaluronic acid (HA) favors selection of spermatozoa without DNA fragmentation and with normal nucleus, resulting in improvement of embryo quality. Fertil Steril 2010; 93: 598–604.

[24] Miller D, Pavitt S, Sharma V, Forbes G, Hooper R, Bhattacharya S, et al. Physiological, hyaluronan-selected intracytoplasmic sperm injection for infertility treatment (HABSelect): A parallel, two-group, randomised trial. Lancet 2019; 393: 416–422.

[25] Novoselsky Persky M, Hershko-Klement A, Solnica A, Bdolah Y, Hurwitz A, Ketzin El Gilad M, et al. Conventional ICSI vs. physiological selection of spermatozoa for ICSI (picsi) in sibling oocytes. Andrology 2021; 9: 873–877.

[26] Sun TCh, Zhang Y, Li HT, Liu XM, Yi DX, Tian L, et al. Sperm DNA fragmentation index, as measured by sperm chromatin dispersion, might not predict assisted reproductive outcome. Taiwan J Obstet Gynecol 2018; 57: 493–498.

[27] Rosiak-Gill A, Gill K, Jakubik J, Fraczek M, Patorski L, Gaczarzewicz D, et al. Age-related changes in human sperm DNA integrity. Aging (Albany NY) 2019; 11: 5399– 5411.

[28] Kaarouch I, Bouamoud N, Madkour A, Louanjli N, Saadani B, Assou S, et al. Paternal age: Negative impact on sperm genome decays and IVF outcomes after 40 years. Mol Reprod Dev 2018; 85: 271–280.

[29] Petersen CG, Mauri AL, Vagnini LD, Renzi A, Petersen B, Mattila M, et al. The effects of male age on sperm DNA damage: An evaluation of 2,178 semen samples. JBRA Assist Reprod 2018; 22: 323–330.

[30] Mangoli E, Khalili MA, Talebi AR, Ghasemi-Esmailabad S, Hosseini A. Is there any correlation between sperm parameters and chromatin quality with embryo morphokinetics in patients with male infertility? Andrologia 2018; 50: e12997.

[31] Ferrigno A, Ruvolo G, Capra G, Serra N, Bosco L. Correlation between the DNA fragmentation index (DFI) and sperm morphology of infertile patients. J Assist Reprod Genet 2021; 38: 979–986.

[32] Mangoli E, Khalili MA, Talebi AR, Kalantar SM, Montazeri F, Agharahimi A, et al. Association between early embryo morphokinetics plus transcript levels of sperm apoptotic genes and clinical outcomes in IMSI and ICSI cycles of male factor patients. J Assist Reprod Genet 2020; 37: 2555–2567.