IMSI – Intracytoplasmic Morphologically selected Sperm Injection. If you are looking to read about this to understand it better, it can be inferred that you are facing infertility issues and are considering infertility treatment, under whose umbrella IMSI treatment falls. Infertility issues are on the rise with modernization and as per a recent study by the Indian Society of Assisted Reproduction, around 10 to 14 percent of our population are facing this issue. It has also noted that the cases are higher in urban areas as compared to the rural areas.
In urban areas, one out of six couples is affected. So, roughly around 27.5 million couples in India are impacted by it. Often, it leads to a lot of emotional turbulence and stress not only on the individuals but also, on the relationship, it is advised to seek Infertility Counselling at the earliest. It is a challenging phase and this problem gets further compounded in a country like India, where motherhood is one of the most important criteria used to measure a woman’s value.
However, with the advancement of science, male infertility treatment, and female infertility treatment have been made possible to treat infertility issues. Various factors cause female and male infertility.We will talk about some of the common causes of female infertility at a very high level in this article (so as not to digress from the main topic that is being discussed here – IMSI). Now, coming back to the causes there could be Ovulation issues, PCOS, Fibroids, Endometriosis, scarring from surgery to the pelvic area, effects of Chemotherapy, and premature ovarian failure.
Before we delve into IMSI, let’s briefly discuss causes for male infertility –
· Productionof healthy sperm goes right back to the stage ofgrowth and formation of the male reproductive organs. At a minimum, one testicle should be working well and produce testosterone and other required hormones that trigger and maintain sperm production.
· Sperm count in the semen – There needs to be enough sperm in the semen. When the number of sperm in the semen is low, it is called oligospermia and it decreases the chances of conceiving. The reason being that as per process the sperm should fertilize the egg.
· Sperm motility – Motility of the sperm may be defined as the sperm’s ability to navigate through the female reproductive tract. If the sperm is unable to swim to the egg of the female, then there are no chances of conceiving.
· Lifestyle and other causes like alcohol, smoking (including passive smoking) substance abuse, weight (obesity affects fertility by, impacting the sperms directly and also by causing hormonal changes that reduce male fertility). Prolonged exposure to certain industrial chemicals like pesticides, herbicides, painting material, etc. High-stress levels also contribute to low sperm count. Overheating the testicles, extremely prolonged sitting, and other inherited infertility disorders.
· As problems vary with each person, a semen analysis is the key to understanding and starting male infertility treatment. Semen analysis is the basic medical diagnostic parameter to check in males. In approximately 30% of the cases, the low sperm count of the male is the reason for infertility. A semen analysis can be done at the best fertility hospital in Hyderabad for precise results.
Based on the findings from the report, additional tests will be done subsequently, usually after a gap of around two to three weeks, as it would help in coming to an accurate analysis.
Decoding the semen analysis test
The test is usually done to check these factors
Sperm count – it is the number of sperms in the semen
Morphology – shape of the sperm
Sperm motility – movement of the sperm
All these above factors are crucial to understanding the reasons for male infertility.
Parameters are set for the semen analysis report and WHO has a reference range. Based, on this, the semen report can be categorized as
Low sperm count – Less than 15 million sperms per milliliter or less than 39 million sperms per ejaculation.
Normal sperm count – From 15 million sperms up to 200 million sperms per milliliter of semen.
High sperm count – Greater than 200 million sperms per milliliter.
Regarding male infertility treatment -for people with low sperm count, some treatment options are IUI (done at an IUI center), IVF and IVF with ICSI ( IntraCytoplasmic Sperm Injection), and IVF with IMSI.
Know all about the IMSI process
IMSI treatment is considered as an advanced IVF procedure. IMSI fertility treatment is a process for men with low sperm count, where the embryologist or scientist selects a single best sperm, basically, the one which has no flaws. Parameters for checking the best sperm are based on motility, morphology, and quantity. A special machine called “micro manipulator” is used to fix the egg and then, this selected sperm is injected with a needle and is put into the egg to facilitate the fertilization process. In straight-forward IVF treatment, egg and sperm are mixed and the sperm needs to get to the egg for fertilization. But, IMSI is a technique for people with low-sperm count whereby the sperm is put into the egg by fixing the egg, thereby increasing the chances of fertilization.
The embryologist/ scientist who performs the IMSI process selects the best sperm after high-magnification of the sperm, as this would enable them to assess the sperm better to see its structure check for all the parameters, and select the one without defects. The usual magnification involved for checking the sperm is only around 400 times, done for ICSI but, for IMSI which is a step further to ICSI, it uses the technique of higher-magnification at around 6,000 to select the best sperm.
This treatment is done in men with a very low sperm count or in men where very few sperms are selected from the palette. It is where the semen is spun or in couples where SSR is performed. SSR- Surgical Sperm Retrieval, is a medical procedure done when there is no sperm in a man’s ejaculation. This is called azoospermia. In such cases, sperm is obtained from the testis using a needle. Overall, it has been noted that better pregnancy rates are achieved through this technique. The journey of becoming parents is long in some cases, it is important to be patient, have the support of your spouse, family, and friends also emotional well-being is very important.