Abstract
BackgroundTo date the IMSI procedure represents the only real-time and unstained method available to discard spermatozoa with ultrastructural defects. Several studies demonstrated that IMSI provides positive results in couples with severe male factor infertility or repeated ICSI failures. Aim of this pilot study is to evaluate the differences between IMSI and ICSI in terms of IVF outcomes in an unselected infertile patient population.MethodsThree hundred and thirty-two couples were analyzed: 281 couples underwent conventional ICSI procedure and 51 underwent IMSI technique.ResultsNo statistically significant differences were found between implantation rate (ICSI: 16,83%; IMSI: 16,67%), fertilization rate (ICSI: 77,27%; IMSI: 80,00%) and pregnancy rate (ICSI: 25,30%; IMSI: 23,50%). Both groups were comparable when considering live birth rate (ICSI: 11,39%; IMSI:13,72%), ongoing pregnancy rate (ICSI: 7,47%; IMSI: 5,88%) and miscarriage rate (ICSI: 17,78; IMSI: 5,26%). The subgroup analyses did not show a statistical difference between ICSI and IMSI neither in male factor infertility subgroup nor in patients with more than one previous ICSI attempt. A trend towards better laboratory and clinical outcomes was detected in the male factor infertility subgroup when IMSI was applied.ConclusionsOur preliminary results show that the IMSI technique does not significantly improve IVF outcomes in an unselected infertile population.
Highlights
To date the IMSI procedure represents the only real-time and unstained method available to discard spermatozoa with ultrastructural defects
In the IMSI group fertilization rate and live birth rate were slightly higher and the miscarriage rate tended to be lower when compared to the Introcytoplasmic sperm injection (ICSI) group, no statistical significance was found
A trend towards better laboratory and clinical outcomes was detected in the male factor infertility subgroup when IMSI was applied
Summary
To date the IMSI procedure represents the only real-time and unstained method available to discard spermatozoa with ultrastructural defects. Several studies demonstrated that IMSI provides positive results in couples with severe male factor infertility or repeated ICSI failures. Aim of this pilot study is to evaluate the differences between IMSI and ICSI in terms of IVF outcomes in an unselected infertile patient population. The power of ICSI as a tool to overcome fertilization failures in IVF procedures has led to a first common acceptance by embryologists that morphology of the selected sperm for injection was of secondary importance [2]. The selection process preceding the micro-injection of a motile, normal-looking spermatozoon into the oocyte’s cytoplasm is usually performed under a low magnification (×200/400) that could be responsible for the underestimation of
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