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Updated: Mar 27, 2026
Mouse Round Spermatid Injection
Published on: January 26, 2024
Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve outcome in patients with two
N Gatimel1,2, J Parinaud3,4, R D Leandri3,4
1Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 Avenue de Grande Bretagne, 31059, Toulouse, France. nicolasgatimel@yahoo.fr.
Purpose:
Assessment of sperm morphology has been reconsidered since 2001 with the development of motile sperm organelle morphology examination (MSOME). This observation technique that combines high magnification microscopy and the Nomarski interference contrast makes it possible to select spermatozoa with as few vacuoles as possible before microinjection into the oocyte (intracytoplasmic morphologically selected sperm injection, IMSI). More than 10 years after the development of IMSI, the indications of the IMSI technique and its ability to increase pregnancy and/or birthrates (compared with conventional ICSI) are still subject to debate. We aimed to better define the interest of IMSI in the third attempt.
Methods:
We assessed the benefit of IMSI by carrying out a retrospective comparative study between IMSI and conventional ICSI during a third ART attempt. Two hundred sixteen couples with two previous ICSI failures were studied between February 2010 and June 2014.
Results:
IMSI did not significantly improve the clinical outcomes compared with ICSI, either for implantation (12 vs 10%), clinical pregnancy (23 vs 21%), or live birth rates (20 vs 19%).
Conclusion:
This study provides supplementary arguments for not achieving IMSI procedure in the third attempt after two previous ICSI failures.
Insights
Intracytoplasmic morphologically selected sperm injection (IMSI) did not improve pregnancy or live birth rates in a third assisted reproductive technology attempt after previous failures. IMSI is not recommended for this patient group.
Area of Science:
- Reproductive Medicine
- Embryology
- Infertility Treatment
Background:
- Motile sperm organelle morphology examination (MSOME) enhanced sperm morphology assessment starting in 2001.
- Intracytoplasmic morphologically selected sperm injection (IMSI) uses high magnification microscopy to select sperm with minimal vacuoles for oocyte microinjection.
- The clinical benefit of IMSI in improving pregnancy and birth rates compared to conventional intracytoplasmic sperm injection (ICSI) remains debated.
Purpose of the Study:
- To evaluate the efficacy of IMSI in couples undergoing a third assisted reproductive technology (ART) attempt following two previous ICSI failures.
- To determine if IMSI offers improved outcomes over conventional ICSI in a specific, challenging patient population.
Main Methods:
- A retrospective comparative study design was employed.
- Two hundred sixteen couples with two prior ICSI failures were analyzed.
- Outcomes were compared between patients who underwent IMSI and those who received conventional ICSI during their third ART attempt (February 2010 - June 2014).
Main Results:
- IMSI did not yield statistically significant improvements in implantation rates (12% vs. 10%).
- Clinical pregnancy rates were comparable between IMSI and ICSI groups (23% vs. 21%).
- Live birth rates also showed no significant difference (20% vs. 19%).
Conclusions:
- The findings suggest that IMSI does not enhance clinical outcomes for the third ART attempt after two prior ICSI failures.
- These results provide additional evidence against the routine use of IMSI in this specific patient cohort.
- Further research may be needed to identify specific subgroups that could benefit from IMSI.
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