• A New IVF Technology for Increasing Success Rates: IMSI

      Over the past few years, the letters IMSI have begun emerging more and more in the IVF literature. IMSI, short for intracytoplasmic morphologically-selected sperm injection, is a procedure used in place of ICSI to increase fertilization rates of eggs in the in vitro fertilization process. ICSI (intracytoplasmic sperm injection) is a common technique in which one sperm is selected and injected directly into an egg. ICSI is used primarily with IVF patients whose fertilization rates are low; however some clinics are choosing to use ICSI with most patients.

      IMSI is used to fine-tune the ICSI process. It allows an embryologist to look at sperm under an extremely high-magnification microscope in order to to look much more critically at sperm morphology. A labor intensive process, IMSI can take an additional two to three hours to examine sperm to find the best-looking (and most genetically promising) sperm to be injected into the available eggs.

      A recent study in the journal Reproductive Biomedicine Online details a meta-analysis of several peer-reviewed scientific studies comparing the outcomes between procedures using IMSI with those using ICSI. The researchers found no difference in fertilization rates between the two methods; however the implantation rates of the IMSI cycles were significantly higher than those of the ICSI cycles. In addition, the rate of miscarriage for the IMSI group was 40% lower than that of the ICSI cycles.

      As IMSI gains more attention, it appears to be a promising option for couples undergoing IVF. Further studies are needed to review the outcomes of this procedure, including the subsequent health and development of babies born as a result of the IMSI technique.

      The development of a modified intracytoplasmic sperm injection (ICSI), called intracytoplasmic morphologically selected sperm injection (IMSI), demonstrated that a profound morphological investigation of the spermatozoon, under the magnification of 6600×, enables outcome improvement. The aim of this study was to compare ICSI outcome with IMSI outcome. The meta-analysis results demonstrated no significant difference in fertilization rate between ICSI and IMSI groups. However, a significantly improved implantation (odds ratio (OR) 2.72; 95% confidence interval (CI) 1.50–4.95) and pregnancy rate (OR 3.12; 95% CI 1.55–6.26) was observed in IMSI cycles. Moreover, the results showed a significantly decreased miscarriage rate (OR 0.42; 95% CI 0.23–0.78) in IMSI cycles as compared with ICSI cycles. This is the first meta-analysis of published data to evaluate the potential benefits of IMSI. The pooled data of IMSI cycles demonstrate a statistically significant improvement in implantation and pregnancy rates and a statistically significant reduction in miscarriage rates. However, more randomized controlled trials are needed to confirm these results.

      The development of a modified intracytoplasmic sperm injection (ICSI) method, called intracytoplasmic morphologically selected sperm injection (IMSI), has enabled the improvement of pregnancy rates. The aim of this study was to perform a systematic review of the literature and compare the fertilization, implantation, pregnancy and miscarriage rates in ICSI and IMSI cycles. Our meta-analysis results demonstrated no significant difference in fertilization between ICSI and IMSI groups. However, implantation and pregnancy rates were almost 3-fold higher in IMSI cycles. Moreover, the miscarriage rate was more than 40% lower in IMSI cycles as compared with ICSI cycles. This meta-analysis demonstrates a significant improvement in implantation and pregnancy rates, and a significant reduction in miscarriage rates. However, further studies are needed to confirm our results.
      Sources:
      Amanda Souza Setti, Renata Cristina Ferreira, Daniela Paes de Almeida Ferreira Braga, Rita de Cássia Sávio Figueira, Assumpto Iaconelli Jr., Edson Borges Jr. (2010). Intracytoplasmic sperm injection outcome versus intracytoplasmic morphologically selected sperm injection outcome: a meta-analysis. Reproductive BioMedicine Online, Volume 21, Issue 4; pp. 450-455.

      "New IVF Technique." Behind the Headlines, NHS Knowledge Service

      Ceram Press Release: IMSI. 10 May 2010. IVF.net
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