Evidence map›Paper›PMID 32772268›Full record

ArticleJournal of assisted reproduction and genetics2020

PICSI vs. MACS for abnormal sperm DNA fragmentation ICSI cases: a prospective randomized trial.

Eman Hasanen, Khaled Elqusi, Salma ElTanbouly, Abd ElGhafar Hussin, Hanaa AlKhadr, Hosam Zaki, Ralf Henkel, Ashok Agarwal

Expression of concern Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of assisted reproduction and genetics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. It is linked to trial NCT03398317 (PICSI vs. MACS for Abnormal Sperm DNA Fragmentation ICSI Cases), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03398317 nacompletednot on this map

PICSI vs. MACS for Abnormal Sperm DNA Fragmentation ICSI Cases: a Prospective Randomized Trial

TypeinterventionalSponsorGanin Fertility CenterRan2017 to 2019Enrolled396ConditionsSperm DNA FragmentationArmsPICSI, MACS
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Sperm Selection Procedures in Cases of High Sperm DNA Fragmentation Index.Advances in experimental medicine and biology · 2026
    Review
  4. Sperm selection for assisted reproductive technology: do we have a winner?Journal of assisted reproduction and genetics · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 3 countries.

Eman HasanenIVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt. em.saberh@gmail.com.ORCID http://orcid.org/0000-0001-8652-0135
Khaled ElqusiIVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt.
Salma ElTanboulyIVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt.
Abd ElGhafar HussinIVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt.
Hanaa AlKhadrIVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt.
Hosam ZakiIVF Laboratory, Ganin Fertility Center, Cairo, 11728, Egypt.
Ralf HenkelUniversity of the Western Cape, Cape Town, South Africa.
Ashok AgarwalAmerican Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
The Egyptian IVF-ET Center · EGCleveland Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo know which sperm selection technique, physiological intracytoplasmic sperm injection (PICSI) or magnetic-activated cell sorting (MACS), is better for the selection of sperm with abnormal sperm DNA fragmentation (SDF) in patients undergoing intracytoplasmic sperm injection (ICSI).

methodsA prospective randomized trial included 413 ICSI cases with abnormal SDF (> 20.3%) by TUNEL assay. Patients with at least 1 million total progressive motile sperm count were randomized to PICSI or MACS groups on the day of ICSI. PICSI depends on the hyaluronan binding of better SDF sperm where individual sperm was selected, while MACS selects non-apoptotic sperm population using Annexin V magnetic beads. All pre-implantation embryogenic parameters were observed and the main outcome was the ongoing pregnancy rate.

resultsThere were no significant differences between patients allocated to PICSI and MACS in the studied parameters including pre-implantation embryological data, implantation, clinical pregnancy, and ongoing pregnancy rates. Meanwhile, sub-analysis according to the female age has shown that female patients with less than 30 years of age in the MACS group had significantly higher good-quality blastocyst, clinical pregnancy, and ongoing pregnancy rates than the PICSI group. However, the higher implantation (p = 0.051), clinical pregnancy (p = 0.078), and ongoing pregnancy (p = 0.097) rates observed in females between 30 and 35 years of age in the PICSI group did not reach significance level.

conclusionsPICSI and MACS are efficient techniques for sperm selection in cases with abnormal sperm DNA fragmentation. However, MACS is preferred when the females are younger than 30 years, while PICSI is preferred in older females. CLINICAL TRIAL REGISTRATION NUMBER: NCT03398317 (retrospectively registered).

Indexed as

Fertilization in VitroSperm Injections, IntracytoplasmicAdultAgedCell SeparationDNA FragmentationEmbryo ImplantationEmbryo TransferFemaleHumansMalePregnancyPregnancy RateProspective StudiesSpermatozoaSperm CountICSIMACSPICSISperm DNA fragmentationSperm selection

Identifiers

PMID32772268
PMCPMC7550434
OpenAlexW3048147491

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.