IMSI or Intracytoplasmic Morphologically Selected Sperm Injection: A Comprehensive Guide

In the world of fertility treatments, advanced techniques like ICSI (Intracytoplasmic Sperm Injection) have revolutionized assisted reproduction, especially for male infertility. However, there’s another highly specialized procedure that offers even more precision: IMSI, or Intracytoplasmic Morphologically Selected Sperm Injection. IMSI is an enhancement of the ICSI technique, focusing on sperm quality by selecting the healthiest sperm based on their morphology, not just their motility. This guide will help you understand IMSI, how it works, why it is performed, and how it differs from ICSI.

What is IMSI or Intracytoplasmic Morphologically Selected Sperm Injection?

IMSI is an advanced fertility treatment where a single sperm is injected directly into an egg, much like in ICSI. However, in IMSI, sperm selection is much more detailed and precise. In this technique, the sperm are first examined under a high-powered microscope (usually with a magnification of 6000x to 8000x, compared to 400x for standard ICSI). This allows the embryologist to observe the sperm’s morphology (shape) in great detail, selecting only the sperm with the highest quality for injection.

The goal of IMSI is to increase the chances of fertilization by selecting sperm with optimal morphology, reducing the chances of using sperm with damaged DNA, which could affect embryo development and pregnancy outcomes.

How Does IMSI Work?

IMSI is performed in several key steps:

1. Ovarian Stimulation: The woman undergoes ovarian stimulation using hormone therapy to produce multiple eggs.
2. Sperm Collection: The sperm sample is collected from the male partner or a sperm donor. If the sperm count is low or the sperm is not motile, sperm may be surgically extracted.
3. Sperm Selection: Unlike traditional ICSI, where sperm is selected based on motility, in IMSI, sperm are examined under a special high-magnification microscope. The embryologist looks for sperm with the best shape and structure, as sperm with abnormal morphology have a higher risk of having damaged DNA, which can result in poor embryo development or miscarriage.
4. Sperm Injection: Once the healthiest sperm is selected based on its morphology, it is injected directly into an egg.
5. Fertilization and Embryo Culture: The eggs are monitored for fertilization, and the embryos are cultured for a few days before being transferred into the woman’s uterus.

Why is IMSI Performed?

IMSI is performed to enhance the chances of fertilization and successful pregnancy, particularly in cases of male infertility. The key reasons for choosing IMSI over traditional ICSI include:

• Improved Sperm Selection: The primary advantage of IMSI is its ability to select sperm based on their morphology (shape) rather than just motility. This increases the chances of choosing sperm with healthy DNA, leading to better fertilization rates and higher quality embryos.
• Overcoming DNA Fragmentation: Sperm with abnormal morphology are more likely to have damaged DNA, which can affect fertilization and embryo development. IMSI helps to minimize the use of sperm with DNA fragmentation, reducing the risk of miscarriage or failed implantation.
• Improved Pregnancy Outcomes: By selecting the best sperm, IMSI may improve pregnancy outcomes, especially for couples with male infertility issues, including low sperm quality or previous IVF failures.

When is IMSI Recommended?

IMSI treatment may be recommended in these situations:

1. Severe Male Infertility: When the male partner has poor sperm quality, such as low sperm count, poor motility, or abnormal sperm morphology, IMSI can help by selecting the best possible sperm.
2. Previous IVF Failures: If previous IVF or ICSI cycles have failed due to poor embryo quality or fertilization issues, IMSI may be recommended to improve the chances of success.
3. High DNA Fragmentation: For men with sperm DNA fragmentation, IMSI can reduce the risk of selecting sperm with damaged DNA, which might result in poor embryo development or miscarriage.
4. Male Factor Infertility with Low Sperm Count: In cases of low sperm count, where sperm quality is compromised, IMSI helps in selecting sperm that are most likely to result in successful fertilization.
5. Unexplained Infertility: For couples where the cause of infertility is unknown but the male partner’s sperm quality is a concern, IMSI can offer a more precise approach to sperm selection.

What is the Difference Between ICSI and IMSI?

The main difference between ICSI and IMSI lies in the sperm selection process:

• ICSI (Intracytoplasmic Sperm Injection): In ICSI, sperm is selected based on motility (how well the sperm move). The sperm with the highest motility is chosen and injected into the egg. This is suitable for cases where male infertility is caused by issues like low sperm count or motility problems.
• IMSI (Intracytoplasmic Morphologically Selected Sperm Injection): In IMSI, sperm is selected based on both motility and morphology (shape). The sperm are examined under a high-powered microscope to select the healthiest sperm with optimal shape. This technique is used when sperm morphology is a concern or in cases of severe male infertility.

In summary, IMSI offers a more detailed and precise approach to sperm selection, particularly useful in cases of sperm with abnormal shape, sperm DNA fragmentation, or previous IVF failures.

What is the Cost of IMSI?

The cost of IMSI treatment is generally higher than traditional ICSI due to the advanced technology involved in sperm selection. 

Additional costs may apply for any additional services, such as genetic testing, sperm extraction procedures, or medication. 

What Are the Risks Associated with IMSI?

While IMSI is a highly effective technique for selecting sperm, it does carry some risks, which include:

1. Higher Costs: IMSI is a more expensive procedure compared to traditional ICSI, which might not be affordable for all couples.
2. Emotional Stress: Like any fertility treatment, IMSI can be emotionally challenging, especially if the procedure does not lead to pregnancy.
3. Sperm Damage: Although IMSI aims to select the healthiest sperm, there is still a risk of DNA fragmentation or damage if the sperm is not carefully chosen or if other factors affect sperm quality.
4. Invasive Nature: Like IVF and ICSI, IMSI involves the collection of eggs and sperm, which can be physically and emotionally taxing for both partners.
5. Limited Success in Certain Cases: While IMSI improves sperm selection, it does not guarantee success, and the treatment may not work for all patients, especially those with more severe infertility problems.

Conclusion

At MotherToBe Fertility Centre, we offer IMSI (Intracytoplasmic Morphologically Selected Sperm Injection), a highly sophisticated and effective technique used in IVF to significantly improve the chances of successful fertilization. This method is particularly beneficial for men with severe sperm abnormalities or those who have faced challenges with previous IVF cycles. IMSI involves selecting sperm based on morphology and motility, ensuring that the healthiest sperm is used for fertilization. This not only enhances embryo quality but also increases the chances of achieving a successful pregnancy.

 

If you’re dealing with male infertility issues and have encountered difficulties with IVF or ICSI, IMSI might be the right solution for you. Our experienced fertility specialists at MotherToBe Fertility Centre can help determine whether IMSI is suitable for your specific needs. With advanced techniques like IMSI, many couples are now able to realize their dream of parenthood, overcoming challenges related to male infertility.

FAQ’s

1. What is IMSI (Intracytoplasmic Morphologically Selected Sperm Injection)?

IMSI is an advanced fertility treatment technique used in conjunction with IVF (In Vitro Fertilization). It involves the selection of sperm under high magnification to assess their morphology (shape) and motility (movement). By carefully selecting the healthiest sperm, IMSI increases the chances of successful fertilization, especially for men with severe sperm abnormalities or previous IVF failures.

2. Who is a good candidate for IMSI?

IMSI is recommended for men with significant sperm issues, such as poor sperm morphology, low motility, or previous failed IVF cycles. It is particularly beneficial for those who have not had success with standard IVF or ICSI (Intracytoplasmic Sperm Injection). If you have a history of male infertility or poor sperm quality, consulting with a fertility specialist can help determine whether IMSI is right for you.

3. How is IMSI different from ICSI?

While both IMSI and ICSI are methods of injecting sperm into an egg during IVF, the key difference is the level of sperm selection. In ICSI, sperm are selected based on their ability to penetrate an egg, but in IMSI, sperm are carefully examined under high magnification (up to 6000x) for their shape and motility before being selected. This detailed evaluation increases the likelihood of choosing healthier sperm, which may improve the chances of successful fertilization and embryo development.

4. What are the benefits of IMSI?

The primary benefit of IMSI is its ability to select healthier sperm, which can lead to better embryo quality and a higher success rate for pregnancy. It is especially beneficial for couples with male infertility factors such as sperm morphology issues, low sperm count, or previous IVF failures. By improving sperm selection, IMSI offers a higher chance of achieving a successful pregnancy compared to traditional IVF or ICSI methods.

5. Are there any risks or side effects associated with IMSI?

IMSI is generally considered safe and is a more refined version of ICSI, but like all fertility treatments, it carries some risks. The main risks associated with IMSI are similar to those of standard IVF and ICSI, such as ovarian hyperstimulation syndrome (OHSS), infection, or multiple pregnancies. However, since IMSI uses high magnification to select sperm, it is a highly controlled procedure, reducing the risk of using sperm with abnormal morphology. It’s important to consult with a fertility specialist to understand the potential risks and benefits in your specific case.