Timing Matters? Impact of Early Sperm Processing on Motile Sperm Recovery, Fertilization, Blastocyst Rate, and Pregnancy Outcomes in IUI and IVF

<b>Background/Objectives:</b> Efficient sperm separation is critical for Assisted Reproductive Technology (ART). This study evaluates how assisted liquefaction (AL), a faster sperm preparation technique, affects motile sperm recovery and ART outcomes. <b>Methods:</b> A prospective pair analysis to address the efficiency of AL and retrospective cohort analysis of IUI and IVF/ICSI cycles were performed. <b>Results:</b> The average time to perform AL was 3 min, in comparison to the 15 to 30 min for traditional liquefaction (TL) until initiating sperm preparation. The total motility (<i>p</i> = 0.252) and progressive motility (<i>p</i> = 0.227) of the sperm samples were about 4% higher in the AL group although there was no significant difference. No significant differences were observed between AL and TL in fertilization (80.0% vs. 81.9%, <i>p</i> = 0.297), blastocyst rates (48.2% vs. 48.1%, <i>p</i> = 0.595), positive pregnancy (70.5% vs. 75.0%, <i>p</i> = 0.667), clinical pregnancy (65.9% vs. 68.4%, <i>p</i> = 0.841), or live birth (52.3% vs. 51.3%, <i>p</i> = 0.831) outcomes in IVF. The Positive pregnancy (<i>p</i> = 0.669) and clinical pregnancy (<i>p</i> = 0.841) of IUI were not significantly different between both groups. <b>Conclusions:</b> AL offers similar results to TL while reducing preparation time without interrupting ART outcomes. AL may have benefit to asthenozoospermia cases for ART due to reduced exposure time of sperm to semen that may prevent sperm quality impact.