Reducing the incidence of early reproductive losses through sperm selection based on membrane zeta potential in assisted reproductive technology

Relevance: Preventing early reproductive losses in assisted reproductive technologies requires comprehensive examination and preparation of the couple, as well as the use of special methods to select high-quality germ cells for fertilization. A promising method for sperm selection is based on the zeta potential of the membrane. However, the indications for using this selection method have not yet been determined, and its effectiveness in Russian couples with infertility remains unknown.

Materials and methods: We conducted a prospective cohort study involving 120 married couples with a history of infertility and early reproductive loss. The study included 62 couples undergoing ICSI with sperm selected based on membrane zeta potential. The control group consisted of 58 couples who underwent ICSI with standard density-gradient sperm isolation. We compared the groups in terms of fertilization and blastulation rates, embryo quality, clinical pregnancy rates, and pregnancy development up to 12 weeks (early reproductive losses).

Results: We observed a statistically significant trend towards higher-quality embryos in the zeta-potential selection group compared to the control group (p<0.001). The pregnancy rate was 35.4% in the study group and 31.0% in the control group (p=0.69; RR=0.87; 95% CI 0.52–1.45). Reproductive loss rates, based on actual pregnancies, were 4.5% in the study group and 33.3% in the control group (p=0.03; RR 0.13; 95% CI 0.01–1.00).

Conclusion: Based on the results obtained, fertilization using ICSI with sperm selection based on membrane zeta potential is effective in reducing the incidence of early reproductive losses. It can be recommended for married couples with male factor infertility, provided that ejaculatory parameters allow selection.