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How to improve IVF-ICSI outcome by sperm selection

A Berkovitz1, F Eltes, H Lederman

  • 1Department of Obstetrics and Gynaecology, Sapir Medical Centre, Meir Hospital, Kfar Saba, Israel.

Reproductive Biomedicine Online
|June 23, 2006
PubMed

Insights

Intracytoplasmic morphologically selected sperm injection (IMSI) significantly improves in vitro fertilization (IVF) outcomes. This method, using motile sperm organellar morphology examination (MSOME), leads to higher pregnancy and lower abortion rates compared to standard IVF-ICSI.

Area of Science:

  • Reproductive Medicine
  • Embryology
  • In Vitro Fertilization

Background:

  • Intracytoplasmic morphologically selected sperm injection (IMSI) is a novel IVF technique.
  • Motile sperm organellar morphology examination (MSOME) is the basis for sperm selection in IMSI.
  • Previous studies suggested IMSI improves IVF-ICSI outcomes by selecting sperm with normal nuclei.

Purpose of the Study:

  • To confirm the improved outcomes of IMSI compared to standard IVF-ICSI in larger patient groups.
  • To evaluate the impact of sperm morphology selection ('best' vs. 'second best') within the IMSI procedure on IVF success rates.

Main Methods:

  • Comparison of IVF-IMSI outcomes with standard IVF-ICSI in 80 couples.
  • Sub-analysis comparing outcomes between 'best' and 'second best' sperm morphology groups within IMSI (n=70).
  • Assessment of pregnancy rates, delivery rates, and abortion rates.

Main Results:

  • IVF-IMSI resulted in significantly higher pregnancy rates (60.0% vs. 25.0%) and lower abortion rates (14% vs. 40%) compared to standard IVF-ICSI.
  • Microinjection with 'best' spermatozoa yielded significantly higher pregnancy (58.2% vs. 25.7%) and delivery rates (52.8% vs. 17.1%), and lower abortion rates (9.7% vs. 33.3%) than 'second best' spermatozoa.
  • P-values were

Conclusions:

  • The study confirms that IMSI, utilizing MSOME for sperm selection, significantly enhances IVF-ICSI success rates.
  • Selecting spermatozoa with strictly normal nuclear morphology ('best') is crucial for maximizing pregnancy and delivery rates and minimizing abortions.
  • The findings strengthen the evidence supporting IMSI as a superior method for improving IVF outcomes.

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