Related Experiment Video
Updated: Apr 25, 2026
Flow Cytometric Analysis of Biomarkers for Detecting Human Sperm Functional Defects
Published on: April 21, 2022
Could sperm grade under high magnification condition predict IMSI clinical outcome?
Christophe Sifer1, Laïla El Khattabi2, Charlotte Dupont1
1Service d'Histologie-Embryologie-Cytogénétique-CECOS, Centre Hospitalier Universitaire Jean Verdier, Assistance Publique - Hôpitaux de Paris, 93143 Bondy, France; Unité de Recherche en Epidémiologie Nutritionnelle, UMR U557 Inserm; U1125 Inra; Cnam; Université Paris 13, CRNH IdF, 93017 Bobigny, France.
Objective:
The aim of this study was to examine whether injection of first-best morphology grade selected spermatozoa improves live birth rate (LBR) compared to intracytoplasmic morphologically selected sperm injection (IMSI) using second-best grade sperm.
Study Design:
In this prospective observational study, 132 patients were enrolled. Inclusion criteria were the presence of severe male factor (normal spermatozoa <10% in fresh ejaculated semen and <10% in selected sperm according to David's classification) associated with ≤2 previous ICSI failure. Results of IMSI performed with either first- or second-best morphology grade spermatozoa (according to Vanderzwalmen's classification) were compared. IMSI attempts performed using mixed first- and second-best grade spermatozoa were excluded (n=41). The primary endpoint was LBR.
Results:
LBR following IMSI was not statistically different using first- (33.3% (13/39)) or second-best morphology grade spermatozoa (28.9% (15/52)). Our study shows that sperm grading under high magnification using Vanderzwalmen's classification is not correlated to IMSI outcome.
Conclusion:
We do not validate Vanderzwalmen classification in our external and prospective series. These results point out the need for improving our knowledge about the impact of observed vacuoles under high magnification condition.
