Effect of injecting slowly motile sperms in intracytoplasmic sperm injection cases with sex selection: a randomized controlled trial

ABSTRACT
Objective. To compare injecting slowly motile sperms versus rapidly motile ones in PGD cases requesting sex selection for family balance.
Materials and Methods. A prospective, randomized controlled clinical trial was done from January 2020 to July 2022. 132 patients seeking intracytoplasmic sperm injection (ICSI) for sex selection in Engab private infertility centre, Alexandria, Egypt, were included. Spermatozoa with slowly progressive motility were selected and used for ICSI (group A = 94), and spermatozoa with rapidly progressive motility were selected and used for ICSI (group B = 38). Day 3 after fertilization, pre-implantation genetic diagnosis (PGD) regarding the gender of the resulted embryos were performed, recorded and compared.
Results. As regards the number of resulted embryos, there was no statistically significant difference between both groups (mean ± SD = 5.26 ± 2.17 for group A, 6.16 ± 2.76 for group B, p = 0.052). The percentage of male embryos to the total embryos was calculated and compared, but there were no statistical differences between groups (%mean ± SD = 36.29 ± 20.82 for group A, 33.99 ± 15.30 for group B, p = 0.442). On the other hand, there was a statistically significant difference when female embryo percentages were compared between groups, in favour of group B (%mean ± SD = 22.78 ± 22.73 for group A, 30.25 ± 20.45, p = 0.031).
Conclusions. Using slowly motile sperms in ICSI cases requiring sex selection, yielded more male embryos, but did not reach statistically significance. On the contrary, using rapidly motile sperms yielded more female embryos and achieved a statistically significant difference.