The impact of microfluidics sperm processing on blastocyst euploidy rates compared to density gradient centrifugation: a sibling oocyte double-blinded prospective randomized clinical trial.

To compare euploidy rates among blastocysts created from sibling oocytes injected with sperm processed by microfluidics or by density gradient centrifugation. Sibling oocyte randomized controlled trial. Single university-affiliated infertility practice. 106 patients aged 18-42 undergoing fresh in vitro fertilization (IVF) cycles with preimplantation genetic testing (PGT) between January 2021 to April 2022 contributed 1442 mature oocytes which were injected with sperm processed via microfluidics or density gradient centrifugation. Sperm sample divided and processed via a microfluidics device and density gradient centrifugation for injection into sibling oocytes. Primary outcome was the embryo euploidy rate. Secondary outcomes included the fertilization, high quality blastulation, and ongoing pregnancy rates. The blastocyst euploidy rate per mature oocyte was not significantly different in the study group compared to the control group (22.9% versus 20.5%, p = 0.60). The blastocyst euploidy rate per biopsied embryo was also similar between the two groups (53.0% versus 45.7%, p = 0.34). However, the fertilization rate per mature oocyte injected was found to be significantly higher in the study group compared to the control group (76.0% versus 69.9%, p = 0.03). The high quality blastulation rate per mature oocyte injected was similar between the two groups, as was the total number of embryos frozen. There were no differences in the number of participants with no blastocysts for biopsy or the number of participants with no euploid embryos between the two groups. Among the male factor infertility and recurrent pregnancy loss subgroups, there were no differences in euploidy rates, fertilization rates, blastulation rates, or total numbers of blastocysts frozen, although the study was underpowered to detect these differences. Seventy-seven patients underwent frozen embryo transfer; there were no significant differences in pregnancy outcomes between the two groups. Microfluidics processing did not improve embryo euploidy rates compared to density gradient centrifugation in this sibling oocyte study, although fertilization rates were significantly higher.

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