{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:49:56Z","timestamp":1787237396476,"version":"build-2736575974"},"reference-count":41,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T00:00:00Z","timestamp":1620777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>The application of MACS non-apoptotic sperm selection in infertility clinics is controversial since the published literature does not agree on its effect on reproductive outcomes. Therefore, it is not part of the routine clinical practice. Classical measures of reproductive success (pregnancy or live birth rates per ovarian stimulation) introduce a bias in the evaluation of a technique\u2019s effect, since only the best embryo is transferred. This retrospective, multicenter, observational study evaluated the impact of MACS on reproductive outcomes, measuring results in classical parameters and cumulative live birth rates (CLBR). Data from ICSI cycles using autologous oocyte in Spanish IVIRMA fertility clinics from January 2008 to February 2020 were divided into two groups according to their semen processing: standard practice (reference: 46,807 patients) versus an added MACS sperm selection (1779 patients). Only when measured as CLBR per embryo transferred and per MII oocyte used was the difference between groups statistically significant. There were no significant differences between MACS and reference groups on pregnancy and live birth rates. In conclusion, results suggest that non-apoptotic sperm selection by MACS on unselected males prior to ICSI with autologous oocytes has limited clinical impact, showing a subtle increase in CLBR per embryo transferred.<\/jats:p>","DOI":"10.3390\/biology10050430","type":"journal-article","created":{"date-parts":[[2021,5,12]],"date-time":"2021-05-12T10:59:12Z","timestamp":1620817152000},"page":"430","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Sperm Selection by Magnetic-Activated Cell Sorting before Microinjection of Autologous Oocytes Increases Cumulative Live Birth Rates with Limited Clinical Impact: A Retrospective Study in Unselected Males"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6863-8981","authenticated-orcid":false,"given":"Mar\u00eda","family":"Gil Juli\u00e1","sequence":"first","affiliation":[{"name":"Andrology and Male Infertility Research Group, IVI Foundation\u2014IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-9245","authenticated-orcid":false,"given":"Irene","family":"Herv\u00e1s","sequence":"additional","affiliation":[{"name":"Andrology and Male Infertility Research Group, IVI Foundation\u2014IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1687-1279","authenticated-orcid":false,"given":"Ana","family":"Navarro-G\u00f3mez Lech\u00f3n","sequence":"additional","affiliation":[{"name":"Andrology and Male Infertility Research Group, IVI Foundation\u2014IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4460-0270","authenticated-orcid":false,"given":"Fernando","family":"Quintana","sequence":"additional","affiliation":[{"name":"IVIRMA Bilbao, Landabarri Bidea, 1\u20133, 2nd Floor, 48940 Leioa Bizkaia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Amor\u00f3s","sequence":"additional","affiliation":[{"name":"IVIRMA Barcelona, Ronda del General Mitre, 14, 08017 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Pacheco","sequence":"additional","affiliation":[{"name":"IVIRMA Madrid, Av. del Talgo 68\u201370, 28023 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Gonz\u00e1lez-Ravina","sequence":"additional","affiliation":[{"name":"IVIRMA Sevilla, Av. de la Rep\u00fablica Argentina, 58, 41011 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Rivera-Egea","sequence":"additional","affiliation":[{"name":"IVIRMA Valencia, Pl. de la Polic\u00eda Local, 3, 46015 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8271-5218","authenticated-orcid":false,"given":"Nicol\u00e1s","family":"Garrido","sequence":"additional","affiliation":[{"name":"Andrology and Male Infertility Research Group, IVI Foundation\u2014IIS La Fe Health Research Institute, Av. Fernando Abril Martorell, 106. Tower A, 1st Floor, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,12]]},"reference":[{"key":"ref_1","unstructured":"WHO (2010). WHO Laboratory Manual for the Examination and Processing of Human Semen, World Health Organization (WHO). [5th ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1093\/humupd\/dmr032","article-title":"Effects of advanced selection methods on sperm quality and ART outcome: A systematic review","volume":"17","author":"Said","year":"2011","journal-title":"Hum. Reprod. 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