Table 1 Advantages and limitations of various sperm selection techniques

Principles

- Utilizes advanced principles for isolating spermatozoa based on functionality and morphology [1,2,3].

- Utilizes magnetic microbeads coated with specific antibodies, such as Annexin-V, to isolate target cells based on their surface markers [4,5,6, 20,21,22,23,24].

- Leverages spermatozoa’s electrical properties for selective isolation [8, 25].

- High-magnification microscopy used to select sperm with optimal genetic and structural attributes [10, 28].

Selectivity and Specificity

- Offers high selectivity for motile and morphologically normal sperm, improving selection outcomes [4, 5].

- Selectively isolates viable sperm with reduced DNA fragmentation, enhancing fertilization and pregnancy rates [7, 22, 24].

- A rapid, non-invasive isolation technique ensures high purity and quality [13, 23].

- Enhances the selection of morphologically normal sperm, improving genetic integrity and pregnancy rates [9, 11, 28].

Cost-Effectiveness

- Initial costs are higher due to specialized equipment, but benefits in outcome efficiency may offset these costs [6, 7].

- Integration costs and technical complexity need further research to justify widespread clinical use [20].

- Requires further validation; optimization of buffer formulations is needed [14].

- Specialized equipment and advanced expertise increase costs and procedural complexity [12, 28, 29].

Efficiency

- Enables real-time monitoring and analysis, increasing ART outcome efficiencies [8, 9].

- Combined with density gradient centrifugation, it shows improved sperm quality and ART success [6, 22, 24].

- Promising in reducing DNA damage and enhancing sperm quality [8, 23, 25].

- Potential to reduce genetic abnormalities and DNA damage in embryos [11, 28].

Standardization

- Crucial to standardize device fabrication and protocols; variations may occur across labs [10, 11].

- High technical complexity; requires dedicated training for lab personnel [20].

- Essential for consistent results across different samples and settings [14, 24].

- Aims to reduce observer variability in sperm selection and morphological assessments [12, 28].

The amount of sperm samples required

- Requires minimal semen, beneficial for cases with limited sample availability [12, 13].

- Efficiently selects viable sperm, minimizing the need for large samples [20].

- Efficiently isolates viable sperm, reducing the need for large samples [8, 25].

- Requires meticulous sample preparation; extended treatment durations may increase patient stress [28].

Ease of Implementation

- Requires specialized technical expertise and training [14,15,16,17].

- Meticulous calibration and quality assurance are needed for clinical integration [20].

- Optimization of buffer compositions and device operation necessary [14, 24].

- High technical proficiency and extended learning curve required for embryologists [29].