Intracytoplasmic morphologically selected sperm injection

The intracytoplasmic morphologically selected sperm injection (IMSI) is a laboratory technique used for In Vitro Fertilisation treatments. High quality sperms are injected into the egg for fertilization, it is an advanced version of ICSI.[1] A high powered microscope is used to pick out and the best sperm cells which are then used in a traditional ICSI protocol. This allows the sperm to be examined in greater detail, including the nucleus which contains the sperm's genetic material. Use of this method has resulted in higher pregnancy and delivery rates and lower abortion rates. IMSI is a good choice for anyone who has failed IVF cycles in the past, and for couples who have a component of male infertility.

History

Introduced in 2001, the intracytoplasmic morphologically selected sperm injection (IMSI) procedure changed the perception of how a spermatozoon suitable for fertilization (via injection into the egg) should appear. A very high powered lens is used to see the sperm in greater detail during the selection process. The spermatozoon is selected at higher magnification; the aim of this is to improve the chance of pregnancy. The use of high magnification for morphological sperm selection prior to ICSI has been associated with higher pregnancy rates and lower miscarriage rate.

Evaluated criteria

Spermatozoa can be considered morphologically suitable for ICSI procedures when the sperm head is regular oval, symmetric and with smooth appearance. it should be 4.5-4.9 μm in length and 3.1-3.5 μm. Nuclear chromatin mass should be homogeneous, with no more than one vacuole, or with a total vacuolar area of less than 4% of nuclear area. also the central part has to be of a normal rectangular shape between 4.0 and 5.0 μm in length.[2]

Indications

Cases where IMSI may be used

  • High levels of DNA fragmentation
  • High levels of sperm aneuploidy
  • The egg quality has appeared to be normal.
  • Repeated early abortions.
  • In patients where there is a history of miscarriage
  • More than 90% of abnormal forms in sperm.

See also

References
  1. Intracytoplasmic morphologically selected sperm injection (IMSI)
  2. Lo Monte, Giuseppe; Murisier, Fabien; Piva, Isabella; Germond, Marc; Marci, Roberto (September 2013). "Focus on intracytoplasmic morphologically selected sperm injection (IMSI): a mini-review". Asian Journal of Andrology. 15 (5): 608–615. doi:10.1038/aja.2013.54. ISSN 1008-682X. PMC 3881647. PMID 23832017.
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