{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T05:38:31Z","timestamp":1769665111563,"version":"3.49.0"},"reference-count":44,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":322,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reprod Medicine &amp; Biology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The selection of high\u2010quality spermatozoa affects embryo quality and, consequently, the success rates of clinical outcomes. This study aimed to evaluate the efficacy of a cumulus cell\u2010based sperm selection method for identifying high\u2010quality spermatozoa and to determine whether this process enhances ICSI clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 88 ICSI cycles were analyzed, generating 640 embryos, 331 in the control group and 309 in the study group. Standard density gradient centrifugation was applied in the control group, while the study group underwent an additional selection step using cumulus cell columns (CCC) in microcapillary pipettes. Embryo development was monitored through time\u2010lapse imaging up to the blastocyst stage, and clinical outcomes were also recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Results demonstrated a significant reduction in sperm DNA fragmentation following CCC selection (37.08% vs. 23.36%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001). Embryos derived from CCC\u2010selected sperm exhibited accelerated developmental kinetics and fewer cleavage abnormalities. Clinical outcomes were markedly enhanced in the study group, with higher implantation (58% vs. 28.4%), chemical pregnancy (81.8% vs. 50%), clinical pregnancy (77.3% vs. 25%), and live birth rates (72.7% vs. 25%) compared with controls (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The Use of cumulus cell\u2010based sperm selection improves embryo quality and reproductive outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/rmb2.70000","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T07:25:03Z","timestamp":1763623503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sperm Selection Using Cumulus Cell Column Improves Sperm\n                    <scp>DNA<\/scp>\n                    Integrity, Embryo Morphokinetics, and Clinical Outcomes Following\n                    <scp>ICSI<\/scp>\n                    : A Randomized Clinical Trial"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4128-6899","authenticated-orcid":false,"given":"Mostafa","family":"Yousefi","sequence":"first","affiliation":[{"name":"Research &amp; Clinical Center for Infertility Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Science  Yazd Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9940-749X","authenticated-orcid":false,"given":"Mohammad Ali","family":"Khalili","sequence":"additional","affiliation":[{"name":"Research &amp; Clinical Center for Infertility Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Science  Yazd Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Eftekhar","sequence":"additional","affiliation":[{"name":"Research &amp; Clinical Center for Infertility Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Science  Yazd Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan J.","family":"Woodward","sequence":"additional","affiliation":[{"name":"X&amp;Y Fertility  Leicester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6967-2305","authenticated-orcid":false,"given":"Fatemeh","family":"Anbari","sequence":"additional","affiliation":[{"name":"Research &amp; Clinical Center for Infertility Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Science  Yazd Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6206-7831","authenticated-orcid":false,"given":"Esmat","family":"Mangoli","sequence":"additional","affiliation":[{"name":"Research &amp; Clinical Center for Infertility Yazd Reproductive Science Institute, Shahid Sadoughi University of Medical Science  Yazd Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.13043"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.4103\/1008-682X.182822"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/aja.aja_99_19"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10815-020-01910-7"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/and.14623"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.theriogenology.2022.08.014"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25189995"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biotechadv.2019.107498"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/adbi.202300621"},{"issue":"7","key":"e_1_2_9_11_1","article-title":"Advanced Sperm Selection Techniques for Assisted Reproduction","volume":"7","author":"Lepine S.","year":"2019","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32989-1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0272.2009.00938.x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.02.005"},{"key":"e_1_2_9_15_1","volume-title":"WHO Laboratory Manual for the Examination and Processing of Human Semen","author":"WHO","year":"2021"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/5566061"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002609"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/and.13798"},{"key":"e_1_2_9_19_1","first-page":"378","article-title":"In Vitro Culture of Human Blastocysts","volume":"1999","author":"Gardner D. 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