IMSI in IVF Treatment

What is IMSI in IVF Treatment?

Choosing the best sperm for microinjection (ICSI) is often not a problem when the sperm quality is good. It becomes difficult to perform ICSI especially in cases where we call terartospermia, that is, the sperm has a head deformity. Studies have shown that sperm deformity reduces the pregnancy rate. Sometimes sperms may have double heads or very large heads or double tails, which embryologists can easily detect under a standard microscope. Apart from this, there may be bubbles in the head of the sperm, which we call vacuoles, and it directly affects fertilization as well as embryo development.

Vacuoles in sperm are not detected at 300 times magnification in a standard microinjection microscope. About 14 years ago, Israeli scientist Bartoov developed a special lens and computer program and observed sperms by magnifying them 2500 to 6000 times and claimed that pregnancy results are better when there is no vacuole in the sperm head. This method, called Intra Cytoplasmic Magnified Sperm Injection (IMSI), is a very popular laboratory technique recently. Since the sperms were looked at with a larger magnification, it was possible to evaluate the small particles of the sperm, which we call organelles.

Is Routine IMSI Application Necessary to Increase Pregnancy Rates?

The long-term clinical use of IMSI is now the question whether the use of the IMSI technique will actually work in the group of patients undergoing general IVF treatment, in other words, should routine IMSI be applied to increase pregnancy rates? The use of IMSI in laboratory studies conducted to date did not change clinical pregnancy rates in patients who underwent IVF for the first time, but it had an effect on increasing pregnancy rates in cases with recurrent IVF failure. The interesting thing is that IMSI is not very effective in azoospermia cases, which we call TESE, that is, in which sperm are obtained by surgical methods. Here, once again, the important thing is that the genetic structure of the sperm is correct, not the shape; There is no 100% connection between shape and genetic structure.

The advancement of technology has made it easier to reach as well as creating standardization in laboratory equipment. As a result, the IMSI system, which can be installed with a simple assembly and software addition, comes to the fore in our patients with recurrent IVF failures. The importance for us physicians is that we have to pay attention to sperm morphology as the male factor in IVF treatment, which we have been focusing on for years.

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