ICSI / IMSI

ICSI

Intracytoplasmic sperm injection (ICSI) is a procedure in which an embryologist looks at sperm through a microscope, selects one, and injects it into a viable egg to incite fertilization.

ICSI is a good solution for those with severe male factor infertility as it bypasses any issues with sperm. It also bypasses the natural fertilization process so only good sperm get a chance to fertilize a woman’s eggs.Studies have confirmed that ICSI rates are higher selecting and using the “best” sperm[1], and that ICSI shows there is no higher risk for malformation and neonatal complications.[2]

IMSI

IMSI stands for intracytoplasmic morphologically elected sperm injection. During IMSI, embryologists look at the sperm more magnified than the ICSI process. While the ICSI process look at sperm at 200-400x, IMSI looks at sperm from 6100x to up to 13,000x. This allows a closer look to ensure the best sperm during selection.[3]

However, the effectiveness of IMSI for clinical practice is still a hot topic. Despite initial studies showing that IMSI had better pregnancy rates[4], further studies have been done that show similar outcomes for ICSI and IMSI.[5] More research is needed to test the effectiveness of IMSI vs. ICSI in the future.[6]

[1] Berkovitz, A, F Eltes, H Lederman, S Peer, A Ellenbogen, B Feldberg, and B Bartoov. 2006. “How to Improve IVF–ICSI Outcome by Sperm Selection.” Reproductive BioMedicine Online 12 (5). Elsevier: 634–38. https://doi.org/10.1016/S1472-6483(10)61191-1.

[2] Bonduelle, M., I. Liebaers, V. Deketelaere, M.-P. Derde, M. Camus, P. Devroey, and A. Van Steirteghem. 2002. “Neonatal Data on a Cohort of 2889 Infants Born after ICSI (1991-1999) and of 2995 Infants Born after IVF (1983-1999).” Human Reproduction 17 (3). Oxford University Press: 671–94. https://doi.org/10.1093/humrep/17.3.671.

[3] "Regular (ICSI) versus Ultra‐high Magnification (IMSI) Sperm Selection for Assisted Reproduction." National Center for Biotechnology Information. July 25, 2013. Accessed April 15, 2018. https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0057740/.

[4] Knez, Katja, Branko Zorn, Tomaz Tomazevic, Eda Vrtacnik-Bokal, and Irma Virant-Klun. "The IMSI Procedure Improves Poor Embryo Development in the Same Infertile Couples with Poor Semen Quality: A Comparative Prospective Randomized Study." Reproductive Biology and Endocrinology 9, no. 1 (August 29, 2011): 123. doi:10.1186/1477-7827-9-123.

[5] Setti, Amanda Souza, Daniela Paes De Almeida Ferreira Braga, Assumpto Iaconelli, Tsutomu Aoki, and Edson Borges. "Twelve Years of MSOME and IMSI: A Review." Reproductive BioMedicine Online 27, no. 4 (October 2013): 338-52. doi:10.1016/j.rbmo.2013.06.011.

[6] Teixeira, D.m., M. Barbosa, R.a. Ferriani, P.a. Navarro, N.j. Raine-Fenning, C.o. Nastri, and W.p. Martins. "EP27.02: Ultra-high Magnification (IMSI) vs Standard Sperm Selection (ICSI) for Assisted Reproduction." Ultrasound in Obstetrics & Gynecology 50, no. S1 (September 16, 2017): 384. doi:10.1002/uog.18754.