Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

The Beneficial Role of Intra Cytoplasmic Morphologically Selected Sperm Injection (IMSI) in Assisted Reproduction

Authors
Esmat Mangoli
Mohammad Ali Khalili
Research and Clinical Center for Infertility, Reproductive Science Institute, Shahid Sadoughi University of Medical Sciences, Tehran, Iran
Abstract
Since the introduction of intracytoplasmic sperm injection (ICSI), the importance of sperm morphology assessment has been given attention in the assisted reproduction field. It is important to select a good-quality motile spermatozoon for giving a better embryo quality in assisted reproduction technique (ART). In ICSI, sperm morphology evaluation is limited due to its low magnification. However, by using intracytoplasmic morphologically selected sperm injection (IMSI), the selection is done at high magnification of ×6600 using motile sperm organelle morphology examination (MSOME). Therefore, it becomes possible to select a good quality spermatozoon with an intact nucleus that may enhance the pregnancy outcomes. Although all patients can benefit from IMSI, it is important to standardize which techniques (IMSI or ICSI) could be used or which group of patients benefit from IMSI to maximize the efficiency of this advanced technology.
Keywords
ICSI
IMSI
Male infertility
sperm morphology
  1. Palermo G, Joris H, Devroey P, Van Steirteghem AC. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet. 1992;340(8810):17-8.
  2. De Vos A, Polyzos NP, Verheyen G, Tournaye H. Intracytoplasmic morphologically selected sperm injection (IMSI): a critical and evidence-based review. Basic Clin Androl. 2013;23:10.
  3. Mangoli E, Khalili MA, Talebi AR, Ghasemi-Esmailabad S, Hosseini A. Is there any correlation between sperm parameters and chromatin quality with embryo morphokinetics in patients with male infertility? Andrologia. 2018;50(5):e12997.
  4. Bartoov B, Berkovitz A, Eltes F, Kogosowski A, Menezo Y, Barak Y. Real-time fine morphology of motile human sperm cells is associated with IVF-ICSI outcome. J Androl. 2002;23(1):1-8.
  5. Kohn TP, Kohn JR, Lamb DJ. Role of sperm morphology in deciding between various assisted reproduction technologies. Eur Urol Focus. 2018;4(3):311-3.
  6. Bartoov B, Berkovitz A, Eltes F. Selection of spermatozoa with normal nuclei to improve the pregnancy rate with intracytoplasmic sperm injection. N Engl J Med. 2001;345(14):1067-8.
  7. Ghazali S, Talebi AR, Khalili MA, Aflatoonian A, Esfandiari N. Large nuclear vacuoles in spermatozoa negatively affect pregnancy rate in IVF cycles. Iran J Reprod Med. 2015;13(7):425-32.
  8. Lo Monte G, Murisier F, Piva I, Germond M, Marci R. Focus on intracytoplasmic morphologically selected sperm injection (IMSI): a mini-review. Asian J Androl. 2013;15(5):608-15.
  9. Bartoov B, Berkovitz A, Eltes F, Kogosovsky A, Yagoda A, Lederman H, et al. Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection. Fertil Steril. 2003;80(6):1413-9.
  10. Delaroche L, Yazbeck C, Gout C, Kahn V, Oger P, Rougier N. Intracytoplasmic morphologically selected sperm injection (IMSI) after repeated IVF or ICSI failures: a prospective comparative study. Eur J Obstet Gynecol Reprod Biol. 2013;167(1):76-80.
  11. Hazout A, Dumont-Hassan M, Junca AM, Cohen Bacrie P, Tesarik J. High-magnification ICSI overcomes paternal effect resistant to conventional ICSI. Reprod Biomed Online. 2006;12(1):19-25.
  12. Setti AS, Braga DP, Figueira RC, Iaconelli A Jr, Borges E. Intracytoplasmic morphologically selected sperm injection results in improved clinical outcomes in couples with previous ICSI failures or male factor infertility: a meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2014;183:96-103.
  13. McDowell S, Kroon B, Ford E, Hook Y, Glujovsky D, Yazdani A. Advanced sperm selection techniques for assisted reproduction. Cochrane Database Syst Rev. 2014;(10):CD010461.
  14. Watanabe S, Tanaka A, Fujii S, Mizunuma H, Fukui A, Fukuhara R, et al. An investigation of the potential effect of vacuoles in human sperm on DNA damage using a chromosome assay and the TUNEL assay. Hum Reprod. 2011;26(5):978-86.
  15. Ebner T, Shebl O, Oppelt P, Mayer RB. Some reflections on intracytoplasmic morphologically selected sperm injection. Int J Fertil Steril. 2014;8(2):105-12.
  16. Garolla A, Fortini D, Menegazzo M, De Toni L, Nicoletti V, Moretti A, et al. High-power microscopy for selecting spermatozoa for ICSI by physiological status. Reprod Biomed Online. 2008;17(5):610-6.
  17. Omidi M, Faramarzi A, Agharahimi A, Khalili MA. Noninvasive imaging systems for gametes and embryo selection in IVF programs: a review. J Microsc. 2017;267(3):253-64.
  18. Berkovitz A, Dekel Y, Goldstein R, Bsoul S, Machluf Y, Bercovich D. The significance of human spermatozoa vacuoles can be elucidated by a novel procedure of array comparative genomic hybridization. Hum Reprod. 2018;33(4):563-71.
  19. Berkovitz A, Eltes F, Yaari S, Katz N, Barr I, Fishman A, et al. The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum Reprod. 2005;20(1):185-90.
  20. Boitrelle F, Guthauser B, Alter L, Bailly M, Bergere M, Wainer R, et al. High-magnification selection of spermatozoa prior to oocyte injection: confirmed and potential indications. Reprod Biomed Online. 2014;28(1):6-13.
  21. Souza Setti A, Ferreira RC, Paes de Almeida Ferreira Braga D, de Cassia Savio Figueira R, Iaconelli A Jr, Borges E Jr. Intracytoplasmic sperm injection outcome versus intracytoplasmic morphologically selected sperm injection outcome: a meta-analysis. Reprod Biomed Online. 2010;21(4):450-5.
  22. El Khattabi L, Dupont C, Sermondade N, Hugues JN, Poncelet C, Porcher R, et al. Is intracytoplasmic morphologically selected sperm injection effective in patients with infertility related to teratozoospermia or repeated implantation failure? Fertil Steril. 2013;100(1):62-8.
  23. Balaban B, Yakin K, Alatas C, Oktem O, Isiklar A, Urman B. Clinical outcome of intracytoplasmic injection of spermatozoa morphologically selected under high magnification: a prospective randomized study. Reprod Biomed Online. 2011;22(5):472-6.
  24. Oliveira JB, Cavagna M, Petersen CG, Mauri AL, Massaro FC, Silva LF, et al. Pregnancy outcomes in women with repeated implantation failures after intracytoplasmic morphologically selected sperm injection (IMSI). Reprod Biol Endocrinol. 2011;9:99.
  25. Antinori M, Licata E, Dani G, Cerusico F, Versaci C, d'Angelo D, et al. Intracytoplasmic morphologically selected sperm injection: a prospective randomized trial. Reprod Biomed Online. 2008;16(6):835-41.
  26. Goswami G, Sharma M, Jugga D, Gouri DM. Can intracytoplasmic morphologically selected spermatozoa injection be used as first choice of treatment for severe male factor infertility patients? J Hum Reprod Sci. 2018;11(1):40-4.
  27. Mangoli E, Khalili MA, Talebi AR, Agha-Rahimi A, Soleimani M, Faramarzi A, et al. IMSI procedure improves clinical outcomes and embryo morphokinetics in patients with different aetiologies of male infertility. Andrologia. 2019;51(8):e13340.
  28. Shalom-Paz E, Anabusi S, Michaeli M, Karchovsky-Shoshan E, Rothfarb N, Shavit T, et al. Can intra cytoplasmatic morphologically selected sperm injection (IMSI) technique improve outcome in patients with repeated IVF-ICSI failure? a comparative study. Gynecol Endocrinol. 2015;31(3):247-51.
  29. Mangoli E, Khalili MA, Eftekhar M, Macchiarelli G, Palmerini MG. First successful live birth following the use of MSOME and time lapse for sperm and embryo selections in a patient with severe male factor infertility: a case report. J Gynecol Obstet Hum Reprod. 2019;48(10):883-5.
  30. Gatimel N, Parinaud J, Leandri RD. Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve outcome in patients with two successive IVF-ICSI failures. J Assist Reprod Genet. 2016;33(3):349-55.
  31. Marci R, Murisier F, Lo Monte G, Soave I, Chanson A, Urner F, et al. Clinical outcome after IMSI procedure in an unselected infertile population: a pilot study. Reprod Health. 2013;10:16.
  32. Setti AS, Braga DP, Figueira RC, Iaconelli A Jr, Borges E Jr. Poor-responder patients do not benefit from intracytoplasmic morphologically selected sperm injection. J Assist Reprod Genet. 2015;32(3):445-50.
  33. Knez K, Tomazevic T, Vrtacnik-Bokal E, Virant-Klun I. Developmental dynamics of IMSI-derived embryos: a time-lapse prospective study. Reprod Biomed Online. 2013;27(2):161-71.
  34. Knez K, Zorn B, Tomazevic T, Vrtacnik-Bokal E, Virant-Klun I. The IMSI procedure improves poor embryo development in the same infertile couples with poor semen quality: a comparative prospective randomized study. Reprod Biol Endocrinol. 2011;9:123.
  35. Leandri RD, Gachet A, Pfeffer J, Celebi C, Rives N, Carre-Pigeon F, et al. Is intracytoplasmic morphologically selected sperm injection (IMSI) beneficial in the first ART cycle? a multicentric randomized controlled trial. Andrology. 2013;1(5):692-7.
  36. Zanetti BF, Braga DPAF, Provenza RR, Figueira RCS, Iaconelli A Jr, Borges E Jr. Sperm morphological normality under high magnification is correlated to male infertility and predicts embryo development. Andrology. 2018 Feb 18. [Epub ahead of print].
  37. Kim HJ, Yoon HJ, Jang JM, Oh HS, Lee YJ, Lee WD, et al. Comparison between intracytoplasmic sperm injection and intracytoplasmic morphologically selected sperm injection in oligo-astheno-teratozoospermia patients. Clin Exp Reprod Med. 2014;41(1):9-14.
  38. de Almeida Ferreira Braga DP, Setti AS, Figueira RC, Nichi M, Martinhago CD, Iaconelli A Jr, Borges E Jr. Sperm organelle morphologic abnormalities: contributing factors and effects on intracytoplasmic sperm injection cycles outcomes. Urology. 2011;78(4):786-91.
  39. Cassuto NG, Hazout A, Hammoud I, Balet R, Bouret D, Barak Y, et al. Correlation between DNA defect and sperm-head morphology. Reprod Biomed Online. 2012;24(2):211-8.
  40. Cassuto NG, Montjean D, Siffroi JP, Bouret D, Marzouk F, Copin H, et al. Different levels of DNA methylation detected in human sperms after morphological selection using high magnification microscopy. Biomed Res Int. 2016;2016:6372171.
  41. De Vos A, Van de Velde H, Bocken G, Eylenbosch G, Franceus N, Meersdom G, et al. Does intracytoplasmic morphologically selected sperm injection improve embryo development? a randomized sibling-oocyte study. Hum Reprod. 2013;28(3):617-26.
  42. Maettner R, Sterzik K, Isachenko V, Strehler E, Rahimi G, Alabart JL, et al. Quality of human spermatozoa: relationship between high-magnification sperm morphology and DNA integrity. Andrologia. 2014;46(5):547-55.
  43. Hammoud I, Boitrelle F, Ferfouri F, Vialard F, Bergere M, Wainer B, et al. Selection of normal spermatozoa with a vacuole-free head (x6300) improves selection of spermatozoa with intact DNA in patients with high sperm DNA fragmentation rates. Andrologia. 2013;45(3):163-70.
  44. Cassuto NG, Bouret D, Plouchart JM, Jellad S, Vanderzwalmen P, Balet R, et al. A new real-time morphology classification for human spermatozoa: a link for fertilization and improved embryo quality. Fertil Steril. 2009;92(5):1616-25.
  45. Figueira Rde C, Braga DP, Setti AS, Iaconelli A Jr, Borges E Jr. Morphological nuclear integrity of sperm cells is associated with preimplantation genetic aneuploidy screening cycle outcomes. Fertil Steril. 2011;95(3):990-3.
  46. Setti AS, Figueira RC, Braga DP, Iaconelli A Jr, Borges E Jr. Gender incidence of intracytoplasmic morphologically selected sperm injection-derived embryos: a prospective randomized study. Reprod Biomed Online. 2012;24(4):420-3.
  47. Luna D, Hilario R, Duenas-Chacon J, Romero R, Zavala P, Villegas L, et al. The IMSI procedure improves laboratory and clinical outcomes without compromising the aneuploidy rate when compared to the classical ICSI procedure. Clin Med Insights Reprod Health. 2015;9:29-37.
  48. Kidd SA, Eskenazi B, Wyrobek AJ. Effects of male age on semen quality and fertility: a review of the literature. Fertil Steril. 2001;75(2):237-48.
  49. Petersen CG, Mauri AL, Vagnini LD, Renzi A, Petersen B, Mattila M, et al. The effects of male age on sperm DNA damage: an evaluation of 2,178 semen samples. JBRA Assist Reprod. 2018;22(4):323-30.
  50. Silva LF, Oliveira JB, Petersen CG, Mauri AL, Massaro FC, Cavagna M, et al. The effects of male age on sperm analysis by motile sperm organelle morphology examination (MSOME). Reprod Biol Endocrinol. 2012;10:19.
  51. Ai L, Liu SY, Huang J, Chen SW, Liu J, Zhong Y. [Intracytoplasmic morphologically selected sperm injection of testicular sperm: clinical outcome in azoospermia patients]. Zhonghua Nan Ke Xue. 2010;16(9):826-9.
  52. Gong Y, Meng XQ, Liu M, Wang J, Xiong F, Zhong Y, et al. [Intracytoplasmic injection of morphologically selected spermatozoa from patients with male factor infertility: clinical and embryo development outcomes]. Nan Fang Yi Ke Da Xue Xue Bao. 2015;35(10):1428-33.
  53. Ghasemzadeh J, Talebi AR, Khalili MA, Fesahat F, Halvaei I, Nabi A, et al. Sperm parameters, protamine deficiency, and apoptosis in total globozoospermia. Iran J Reprod Med. 2015;13(8):495-502.
  54. Talebi AR, Ghasemzadeh J, Khalili MA, Halvaei I, Fesahat F. Sperm chromatin quality and DNA integrity in partial versus total globozoospermia. Andrologia. 2018;50(1).
  55. Khalili MA, Kalantar SM, Vahidi S, Ghafour-Zadeh M. Failure of fertilization following intracytoplasmic injection of round-headed sperm. Ann Saudi Med. 1998;18(5):408-11.
  56. Khalili MA, Aflatoonian A, Zavos PM. Intracytoplasmic injection using spermatids and subsequent pregnancies: round versus elongated spermatids. J Assist Reprod Genet. 2002;19(2):84-6.
  57. Sermondade N, Hafhouf E, Dupont C, Bechoua S, Palacios C, Eustache F, et al. Successful childbirth after intracytoplasmic morphologically selected sperm injection without assisted oocyte activation in a patient with globozoospermia. Hum Reprod. 2011;26(11):2944-9.
  58. Chelli MH, Albert M, Ray PF, Guthauser B, Izard V, Hammoud I, et al. Can intracytoplasmic morphologically selected sperm injection be used to select normal-sized sperm heads in infertile patients with macrocephalic sperm head syndrome? Fertil Steril. 2010;93(4):1347.e1-5.
  59. Cassuto NG, Hazout A, Bouret D, Balet R, Larue L, Benifla JL, et al. Low birth defects by deselecting abnormal spermatozoa before ICSI. Reprod Biomed Online. 2014;28(1):47-53.
  60. Hershko-Klement A, Sukenik-Halevy R, Biron Shental T, Miller N, Berkovitz A. Intracytoplasmic morphologically selected sperm injection and congenital birth defects: a retrospective cohort study. Andrology. 2016;4(5):887-93.
  61. Gaspard O, Vanderzwalmen P, Wirleitner B, Ravet S, Wenders F, Eichel V, et al. Impact of high magnification sperm selection on neonatal outcomes: a retrospective study. J Assist Reprod Genet. 2018;35(6):1113-21.
Journal of Reproduction & Infertility
Volume 21, Issue 1
Winter 2020
Pages 3-10