Publication:

Comparison of reproductive outcomes in ICSI cycles after sperm selection techniques in advanced paternal age

Background Advanced paternal age is associated with declining semen parameters, increased sperm DNA fragmentation (SDF), and oxidative stress, which may negatively affect ART outcomes. Microfluidic sperm sorting has been proposed as a method to reduce SDF and improve sperm quality compared to conventional density gradient centrifugation.

Methods Single-center retrospective cohort study including 193 ICSI cycles performed between January 2023 and December 2024. Couples were stratified by male age ( 0.05). Fertilization and blastulation rates were comparable across subgroups. A modest reduction in oocyte yield was noted in older males undergoing microfluidic preparation (A2 vs. B2; p=0.034), likely reflecting female- or cycle-specific factors. Demographic/clinical data are detailed in tables in the results section. Multivariate logistic regression showed that female age (OR 1.02, 95% CI 0.96–1.09, p=0.50) and subgroup membership were not significant predictors of clinical pregnancy. Pairwise comparisons with Tukey adjustment confirmed no significant differences between subgroups (e.g., A1 vs. B1: OR 1.91, p=0.515). conclusion: Male age ≥40 years and sperm preparation method (microfluidics vs. density gradient) were not independent determinants of ART success in this cohort. Clinical decision-making regarding sperm selection should not be guided solely by paternal age or subgroup classification.