Many couples who are unable to conceive naturally turn to various forms of assisted reproduction. One of the procedures offered by reproductive medicine is Intracytoplasmic Morphologically Selected Sperm Injection, or IMSI for short. In this procedure, the man’s sperm are examined under a special microscope at high magnification prior to artificial insemination. The goal is to use the highest-quality sperm for the treatment.
Here you can find more information and specialists.
The abbreviation IMSI stands for Intracytoplasmic Morphologically Selected Sperm Injection, which is a further development of ICSI (Intracytoplasmic Sperm Injection).
In both methods, specialists inject a sperm cell directly into the egg outside the body. If fertilization is successful, doctors continue to culture the egg until it reaches a specific embryonic stage. They then transfer it back into the woman’s body. This increases the chances of pregnancy.
A key feature of the IMSI method is that experts specifically select the sperm for fertilization in advance.
To understand how IMSI works, you should know how the underlying ICSI procedure works:
- In intracytoplasmic sperm injection (ICSI), doctors inject the man’s sperm into the woman’s egg.
- This method is typically used when the man’s sperm quality is not optimal. A semen analysis provides information on this.
- It is then used when in vitro fertilization has not been successful.
- In vitro fertilization is also colloquially referred to as “test-tube fertilization” because it takes place outside the body.
- The ICSI method is also used when there are no sperm in the man’s ejaculate. In such cases, experts extract sperm directly from the testicles or epididymis.
Artificial fertilization of an egg © Tatiana Shepeleva /AdobeStock
Advantages of IMSI
The advantage of IMSI is that experts carefully examine and analyze the sperm beforehand. They observe the sperm at a magnification of 1,600 to 16,000 times.
In contrast, the ICSI method uses only 200- to 400-fold magnification. A special microscope with dedicated software is used to select sperm during the IMSI procedure.
The microscope displays the sperm, and the software evaluates the displayed results and performs the selection. This high magnification is made possible by differential interference contrast (DIC). The IMSI method is very complex and time-consuming and requires a high-end microscope.
This allows experts to specifically select sperm that show no abnormalities in shape or structure.
Possible abnormalities include:
- vacuoles (fluid-filled cavities) or
- fragmentation (breakdown) of the cell nucleus
Consequently, higher-quality sperm are available for fertilizing the egg.
The advantages of IMSI:
- Magnified view of the sperm
- Detection of specific structural or morphological abnormalities
- Selection of high-quality sperm
- Selection of suitable sperm under the microscope
Criticism of the IMSI method
Patients for whom the conventional ICSI method was unsuccessful may, under certain circumstances, benefit from the IMSI method.
Some studies indicate that IMSI has achieved a significant increase in pregnancy rates. This is due to the higher-quality sperm.
However, there are also critics of this method, some of whom have serious doubts about the study results. The most common criticism is that low-quality sperm can also be identified using the standard ICSI method.
The use of a microscope that magnifies the sperm does not provide the claimed benefits. While experts can detect abnormalities in the “head” of the sperm using IMSI, it is unclear whether these affect fertility.
IMSI Procedure
Patients who wish to conceive using the IMSI method can choose from various fertility clinics.
It is important to choose a facility with knowledgeable and experienced staff. You should assess all medical and psychological factors in advance and, if necessary, consider other methods. This is because the causes of infertility are diverse.
Options in Reproductive Medicine
Costs of IMSI
IMSI is a purely private service that health insurance plans do not cover or co-pay. It is not possible to give a general answer regarding the final cost.
Ethical Considerations Regarding IMSI and ICSI
Since these treatment methods are forms of artificial insemination, they are not entirely uncontroversial.
This is because many people view this interference with nature very critically. Whether birth defects are a consequence of artificial insemination has not yet been clarified.
