Semen quality is frequently used as an indirect measure of male infertility. However, these traditional criteria provide little indication of possible nuclear DNA damage. DNA fragmentation in spermatozoa has been associated with poor semen quality, low fertilization rates, impaired preimplantation development, and high miscarriage rates.

MACS is a flexible, fast and simple cell sorting system for separation of cells; and employing annexin V microbeads can effectively remove apoptotic sperm. Hence, sperm cells prepared by MACS have high motility, viability, morphology, and display reduced apoptosis manifestations, including DNA fragmentation.

Additionally, by selecting non-apoptotic sperm by MACS, we can achieve satisfactory pregnancy and implantation rates, rendering the procedure a good option for couples with high sperm DNA fragmentation and repeated assisted reproduction failures.