Investigation of sperm quality thoroughly & minutely.

IMSI or intracytoplasmic morphologically selected sperm injection is a laboratory technique used for infertility treatments with In Vitro Fertilization. The technique involves the insertion of morphologically selected sperm into the egg. By conducting a sperm sorting prior to insemination, sperm with abnormalities that could potentially hinder pregnancy can be discarded.

The technique of IMSI IVF is similar to intracytoplasmic sperm injection or ICSI. Both work by microinjecting spermatozoa inside the collected oocytes. These techniques are usually meant for couples who have a severe issue with male infertility.

The magnification of sperm in IMSI is almost 15 times higher than the magnification in ICSI. High magnification provides higher resolution and better contrast to assist with the examination of sperm. This allows selecting normal sperms among numerous abnormal sperms. The normal sperms are then injected into the egg, hence resulting in embryos of better quality. Selecting sperm without the defects reduces the rates of miscarriage and increases IMSI IVF success rate. After selecting the sperm, the rest of the IMSI fertility treatment is the same as ICSI.

On the day of the procedure, our embryologists prepare a semen sample. The semen sample may be fresh or frozen. Our embryologists have special training in ICSI and IMSI technique and they select a single sperm for injection under a microscope. Just like regular ICSI, the eggs are collected and then washed and examined for determining which eggs are mature so that they can be injected.

Aspiration of sperm is done with the help of a fine glass needle. The sperm is injected into the eggs previously selected. Overnight culture of the injected eggs is done

With the help of the IMSI procedure, our embryologists can prevent sperm that is abnormal or structurally deficient from entering and fertilizing an egg. That is why this procedure is usually recommended for men whose semen contains more than the regular amount of abnormal sperm. IMSI may be a preferable treatment option when IVF with ICSI hasn’t worked in previous attempts. When IVF is performed with IMSI, the selection mechanism is enhanced, possibly increasing the chance of fertilization and normal growth of the embryo.

Following are the conditions when the IMSI fertility treatment may be recommended:

• Men with poor sperm morphology. Poor morphology of the sperm is known to increase the susceptibility of the sperm to oxidation damage.
• Men having a high level of DNA fragmentation on the sperm. DNA fragmentation indicates oxidation damage.
• Couples having a smaller number of embryos that develop to the blastocyst stage.
• Couples who haven’t achieved pregnancy despite multiple attempts of embryo transfer.
  

Upon a successful IMSI, the embryo that results from it can be transferred to the womb of the mother. In some cases, the mother isn’t fit enough for sustaining a pregnancy. In such cases, the best option might be surrogacy treatment.

The process of IMSI involves microinjection of only the sperm that are best morphologically into an egg. That is why it is considered that IMSI has a high chance of success as compared to general ICSI. On average the IMSI IVF success rate varies between 35%-50% per IMSI cycle. The cause of infertility plays a major role in determining the success rate. When comparing the children conceived naturally and the ones conceived through infertility treatment, no significant difference has been found in terms of birth defects, prenatal stress or behavioural problems.

IMSI is said to improve the rate of success among men with the worst infertility prognosis. Also, IMSI is considered to be a more beneficial option than ICSI when the previous two attempts of IVF have failed with ICSI. It may even be considered a useful option for couples with unexplained infertility. IMSI is known to result in a better rate of fertilization, improved embryo, better formation of the blastocyst and hence improved rate of pregnancy.

As you would expect, the cost of IMSI treatment is higher as compared to that of ICSI. However, the difference in cost isn’t that significant

IMSI can be said to be an extension of ICSI. It simply involves an additional step of a non-invasive test that is performed on the semen sample. Any risk associated with ICSI is also applicable to IMSI. There isn’t any additional risk to the embryo or the patient.

Over recent years, several studies and reviews have been conducted that suggest IMSI may be beneficial in particular situations like a prior failure with ICSI attempts.