There are two methods of functional sperm selection, that your doctor may recommend to you: MACS,  magnetically activated cell sorting and PICSI,  a physiological selection of sperm before ICSI. What can you imagine, when thinking about them, and what are their advantages and disadvantages?

Both of these methods are selected on the basis of the following indications: pathological spermiogram (especially the proportion of normal sperm under 2 %), poor DNA integrity in sperm (over 20-30 % of sperm with fragmented DNA), partner‘s age, previous abortions, IVF failures, etc. indicate that both methods should be combined.


  • With PICSI, due to hyaluronan binding (egg-binding simulation), well-mature sperm are selected.
  • Sperm are selected individually, which means longer and more demanding manipulation.
  • Sperm can be affected by the used media.
  • For the processing, the presence of well-moving sperm is necessary.
  • Based on our experience, it is only recommended in the indicated cases, otherwise it has a negative influence due to the handling time.


  • The magnetic separation method separates the sperm in the early stage of cell death (when it still does not need to show any change).
  • The entire sperm population is selected at once.
  • Higher price compared to PICSI.
  • Reagents only bind to the sperm to be removed. The population of sperm to be used remains unaffected.
  • In the extreme case, it can also be done on immobile sperm.
  • It can be done even if the indication is noc completely obvious – it cannot hurt.

In Sanatorium Helios we have tested the DNA integrity before and after the MACS method. On average, the proportion of sperm with fragmented DNA decreased by more than two-thirds of the original value.

Always discuss your fertilization methods with your doctor who will help you choose the most appropriate method or combination of methods for you based on all the information and the test results.

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