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Short communication

Vol. 143 No. 0708 (2013)

First successful pregnancy in Switzerland after prospective sex determination of the embryo through the separation of X-chromosome bearing spermatozoa

  • Christian De Geyter
  • Oliver Sterthaus
  • Peter Miny
  • Friedel Wenzel
  • Olav Lapaire
  • Maria De Geyter
  • Gideon Sartorius
Cite this as:
Swiss Med Wkly. 2013;143:w13718


QUESTION UNDER STUDY: The feasibility and the potential advantages of separating X-chromosome bearing spermatozoa for the prevention of a severe X-chromosome linked disorder with the use of intracytoplasmic sperm injection are presented.

METHOD: A carrier of muscular dystrophy type Becker was treated with intracytoplasmic sperm injection, using spermatozoa previously stained with the Hoechst dye 33342 and sorted with flow cytometry.

RESULTS: After transfer of one single blastocyst, an intrauterine pregnancy arose. In the ninth week of gestation, the female sex of the embryo was confirmed with proof of absence of the SRY gene of the Y-chromosome. After normal pregnancy, the patient delivered a healthy daughter.

CONCLUSIONS: The staining of spermatozoa with specific markers and sorting with flow cytometry provides a means of preventing significant disease in the offspring and may help in reducing the number of surplus embryos needed for preimplantation genetic diagnosis.


  1. De Geyter C. Assisted reproductive medicine in Switzerland. Swiss Med Wkly. 2012;142:w13569.
  2. Imthurn B, Achermann J, Klug Arter M, Macas E. Preimplantation diagnosis in Switzerland – birth of a healthy child after polar body biopsy. Swiss Med Wkly. 2004;134:254–8.
  3. Joris H, Van den Abbeel E, Vos AD, Van Steirteghem A. Reduced survival after human embryo biopsy and subsequent cryopreservation. Hum Reprod. 1999;14:2833–7.
  4. Zhang X, Trokoudes KM, Pavlides C. Vitrification of biopsied embryos at cleavage, morula and blastocyst stage. Reprod Biomed Online. 2009;19:526–31.
  5. Pinkel D, Gledhill BL, Lake S, Stephenson D, Van Dilla MA. Sex preselection in mammals? Separation of sperm bearing Y and “O” chromosomes in the vole Microtus oregoni. Science. 1982;218:904–6.
  6. Satz AL, White CM, Beerman TA, Bruice TC. Double-stranded DNA binding characteristics and subcellular distribution of a minor groove binding diphenyl ether bisbenzimidazole. Biochemistry. 2001;40:6465–74.
  7. Watkins AM, Chan PJ, Kalugdan TH, Patton WC, Jacobson JD, King A. Analysis of the flow cytometer stain Hoechst 33342 on human spermatozoa. Mol Hum Reprod. 1996;2:709–12.
  8. Garner DL. Hoechst 33342: the dye that enabled differentiation of living X-and Y-chromosome bearing mammalian sperm. Theriogenology. 2009;71:11–21.
  9. Hossain MS, Johannisson A, Wallgren M, Nagy S, Siqueira AP, Rodriguez-Martinez H. Flow cytometry for the assessment of animal sperm integrity and functionality: state of the art. Asian J Androl. 2011;13:406–19.
  10. Tubman LM, Brink Z, Suh TK, Seidel Jr. GE. Characteristics of calves produced with sperm sexed by flow cytometry. J Anim Sci. 2004;53:1029–36.
  11. Parrilla I, Vázquez JM, Cuello C, Gil MA, Roca J, Di Berardino D, Martínez EA. Hoechst 33342 stain and u.v. laser exposure do not induce genotoxic effects in flow-sorted boar spermatozoa. Reproduction. 2004;128:615–21.
  12. Karabinus DS. Flow cytometric sorting of human sperm: MicroSort clinical trial update. Theriogenology. 2009;71:74–9.
  13. Johnson LA, Welch GR, Keyvanfar K, Dorfmann A, Fugger EF, Schulman JD. Gender preselection in humans? Flow cytometric separation of X and Y spermatozoa for the prevention of X-linked diseases. Hum Reprod. 1993;10:1733–9.
  14. Vidal F, Fugger EF, Blanco J, Keyvanfar K, Català V, Norton M, Hazelrigg WB, Black SH, Levinson G, Egozcue J, Schulman JD. Efficiency of MicroSort flow cytometry for producing sperm populations enriched in X- or Y-chromosome haplotypes: a blind trial assessed by double and triple colour fluorescent in-situ hybridization. Hum Reprod. 1998;13:308–12.
  15. American College of Obstetricians and Gynecologists Committee on Genetics. Carrier screening for fragile X syndrome. Obstet Gynecol. 2010;116:1008–10.
  16. ESHRE Capri Workshop Group. Genetic aspects of female reproduction. Hum Reprod Update. 2008;14:293–307.
  17. Streuli I, Fraisse T, Ibecheole V, Moix I, Morris MA, de Ziegler D. Intermediate and premutation FMR1 alleles in women with occult primary ovarian insufficiency. Fertil Steril. 2009;92:464–70.
  18. Karimov CB, Moragianni VA, Cronister A, Srouji S, Petrozza J, Racowsky C, Ginsburg E, Thornton KL, Welt CK. Increased frequency of occult fragile X-associated primary ovarian insufficiency in infertile women with evidence of impaired ovarian function. Hum Reprod. 2011;26: 2077–83.
  19. Wittenberger MD, Hagerman RJ, Sherman SL, McConkie-Rosell A, Welt CK, Rebar RW, Corrigan EC, Simpson JL, Nelson LM. The FMR1 premutation and reproduction. Fertil Steril. 2007;87:456–65.
  20. Goosens V, Traeger-Synodinos J, Coonen E, De Rycke M, Moutou C, Pehlivan T, et al. ESHRE PGD Consortium data collection XI: cycles from January to December 2008 with pregnancy follow-up to October 2009. Hum Reprod. 2012;27:1887–911.