How to improve IVF-ICSI outcome by sperm selection

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.