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Couple infertility is gradually increasing, and couples unable to conceive naturally are dependent on assisted reproductive techniques (ART). Intracytoplasmic sperm injection (ICSI) bypasses the natural selection process of sperm in the female reproductive tract, hence sperm-handling techniques are used to select the most suitable sperm for oocyte fertilization. In this chapter we discuss the conventional sperm-processing methods such as swim-up and density gradient centrifugation. Furthermore, advanced techniques such as magnetic-activated cell sorting, microfluidic devices, motile sperm organelle morphology examination, flow cytometry, and zeta potential are presented. We provide an overview of the sperm-handling approach and its outcome in ART. Additionally, we highlight the future sperm-handling techniques such as Raman spectrometry, interferometric phase microscopy, confocal light absorption and scattering spectroscopy, proteomic analysis, and peptide-based selection of sperm.
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