Magnetic Activated Cell Sorting (MACS)

MACS is a technique that allows sperm with the best characteristics to be selected, eliminating those destined to die without achieving fertilization and choosing the healthiest ones, which increases the possibility of pregnancy.

MACS is a method to select a non-apoptotic sperm. Apoptotic or apoptosis-like manifestation sperm have an externalized phosphatidylserine (EPS) on sperm surface, EPS is a marker of apoptotic or apoptosis-like manifestation sperm which have a DNA damage or sperm DNA fragmentation. DNA damage will lead sperm to have programmed cell death. There are many factors that have effect to sperm DNA such as environmental and lifestyle factors, systemic diseases, or primary cause of male reproductive tract.

Sperm with normal morphology may have some degree DNA fragmentation. sDNAfrag will affect the quality of embryos in term of low blastocyst development rate, low pregnancy rate and high miscarriage rate. In a recent year, there is a meta-analysis which study about sDNA frag and risk of miscarriage rate. They found that miscarriage rate have higher in sDNAfrag group around 2.16 times when compare with control group.

The advantage of MACS

MACS has an advantage over a conventional sperm preparation (SW or DGC) in term of decrease DNA fragmentation of sperm, which have MMP, CP-9 and EPS, more oocyte penetration potential sperm.
The advantage of MACS confirms by the recent publication, they found that sperm preparation by MACS + DGC will have more pregnancy rate around 1.5 times when compare with DGC alone.

How MACS works

Before the separation, damaged apoptotic sperm is labelled with magnetic nanoparticles, and then they are put through a column, where the apoptotic sperm is captured.
Intact live sperm flow through the column and are collected for any fertilization technique in assisted reproduction. 

Why perform MACS?

MACS greatly increases the chance of:

  • The fertilization of more eggs
  • The obtaining of more embryos
  • Further development of large quantities of embryos

Who can benefit from MACS?

  • TUNEL or SCSA assay show a DNA fragmentation (DFI)
  • History of repeated or recurrent IVF/ICSI failure
  • Abnormal sperm parameter or varicocele

Sperm preparation with MACS will have advantages in some couples who have several infertility treatment failure or severe abnormal sperm parameters.