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What is IMSI (Intracytoplasmic Morphologically Selected Sperm Injection)?

  • 4.8 (6 Votes)
  • 11563 views

IMSI (Intracytoplasmic Morphologically Selected Sperm Injection) is a technique used in conjunction with IVF to combat male infertility issues. High quality sperms are injected into the egg for fertilization. It is an advanced version of ICSI.

What is IMSI?

IMSI stands for Intracytoplasmic Morphologically Selected Sperm Injection and is a modification of the standard ICSI procedure. IMSI is a method used during IVF in which assessment and selection of sperms are done through the use of high magnification digital imaging microscope for the purpose of injecting into the egg.

Why is IMSI preferred over ICSI?

It is suggested that IMSI may improve pregnancy rates in some patients. The major reason why IMSI is preferred over ICSI is as follows:

  • IMSI involves a usage of a higher magnification microscope to assess sperm morphology.
  • At a higher power, the embryologist can identify tiny defects in the sperm head that would not otherwise be visible with standard ICSI.
  • The selection of those sperms may improve results for couples with embryo implantation failures, severe teratozoospermia (abnormal sperm shape) or high levels of DNA fragmentation.

It might interest you: How Long Does Sperm Live?

When not to go for IMSI?

IMSI procedure is complex and time consuming. There is a strict criterion regarding who might be offered this technique. Go for IMSI, only if benefits of IMSI outweigh benefits of ICSI.

1- If there is no clinically proven data that IMSI will improve patient’s outcome.

2- Additional time constraints are having a negative impact on the fertilization of the egg.

imsi tool

IMSI is a selection tool, to aid embryologists in selecting the best sperm for ICSI. IMSI will not be suitable technique if the sperm count or motility already limits the number of sperm available for ICSI.

When to perform IMSI?

IMSI is a procedure that stands out for its exclusivity. One just cannot opt for IMSI without a Doctor’s/Clinic’s approval. You must meet the criteria discussed below to get IMSI done along with IVF

1- Two failed IVF with ICSI Cycles(Failed cycles with no pregnancy or first trimester miscarriage).

2- More than 90% of abnormal forms in sperm.

3- IMSI can be done if the male does have sufficient motile sperm for selection.

4- Males who show high sperm DNA fragmentation. Sperm DNA fragmentation indicates there is a problem in the genetic material of the sperm and hence it will result in IVF failures and infertility.

Please note that even if you meet one of these criteria, you may be excluded if there are an insufficient number of motile sperms in the sample on the day of egg collection.

What is the procedure of IMSI?

1- Fertility medications are given to the woman to stimulate the ovaries for the development of multiple mature follicles.

2- The woman is given an hCG (human chorionic gonadotropin) injection prior to 36 hours of egg collection. hCG hormone induces ovulation and eggs become ready to be released.

hCG injection

3- The woman is given local anesthesia before performing egg extraction process.

4- Gynecologist uses a needle to extract mature eggs from the ovaries.

5- Sperms are collected and studied under high power microscope which can magnify the sperm size to 6000 times of its original size.

For more information, read: What is Normal Sperm Count for Pregnancy

6- Embryologists identify sperms normal in size and shape. They also look out for the sperm with higher motility.

7- Once the higher quality sperm is detected, it is injected into the egg for the fertilization of the egg.

What is the cost of IVF with IMSI treatment?

The cost of IVF with IMSI ranges from INR 2.5 lakhs to INR 3.2 lakhs.

ICSI vs. IMSI

1- IMSI is considered one of the most refined methods of ART (Assisted Reproductive Technology). It is an advanced version of ICSI.

2- The time factor involved during the IMSI procedure acts against it most often. IMSI takes longer time than ICSI.

3- IMSI can sometimes reduce the chances of conception also. Normally, during IMSI, it takes a long time to observe and pull out the best sperm from the sample. Until that time, the eggs are already collected and due to a long exposure, there are chances of the eggs getting damaged quite often as they are extra sensitive.

4- IMSI process is more costly as compared to ICSI.

What are the advantages of IMSI?

IMSI procedure has been able to catch a lot of attention due to their deep rooted scientific engagement. Some of the benefits of IMSI are-

  • IMSI entails objective classification of sperm which almost removes the risk of inter-technician variation.
  • IMSI delivers fast and rapid analysis, which is scientifically based.
  • IMSI allows standardization of user-selected sperm for ICSI.
  • In IMSI, no manual measurements of sperm are required.
  • As IMSI involves the latest technology, one can save videos and snapshots of the sperm assessment and selection procedure for quality control and archiving.
  • When the couples face repeated unsuccessful IVF cycles, IMSI is an option to improve the chances of success.

Disadvantages of IMSI

  • IMSI is a time consuming process ranging from 5 to 5 hours.
  • It involves higher cost due to the usage of a high magnifying microscope.
  • Sometimes, overtime in selecting the best sperm can damage the egg. Hence, IMSI process may not be effective in improving fertilization of the egg.

Does IMSI really improve IVF success rate?

1- It is medically tested that there is not much difference in the pregnancy rate with ICSI and IMSI. The main difference lies in the delivery rate in both the methods. Females with IMSI treatment deliver live and defect free babies as compared to the ICSI patients.

2- IMSI showed higher pregnancy rates for the couples when they opt for this technique after failed ICSI cycle rather than going again for ICSI.

3- It decreases the chances of miscarriage.

Surely, IMSI is an advanced technology which can identify high quality sperms. It can stop birth defects and pregnancy failure related to sperm abnormality. But IMSI is a time consuming and complex procedure. It is better to medically analyze the benefits of IMSI for a patient before performing it.

If you have low sperm count, you will be happy to know that it can be boosted naturally. Please read our article on Boost Male Fertility and Sperm Count Naturally.

Dr. Surveen Ghumman

About The Author

Infertility Specialist, Obstetrician Dr. Surveen Ghumman
Delhi

Dr. Surveen Ghumman is an infertility specialist and gynecologist specializing in IVF, Reproductive Endocrinology, Recurrent failures of implantation, Embryology, Fertility preservation and Surrogacy. Dr. Surveen has completed MBBS from Christian Medical College, Ludhiana in 1986 and MD in Obstetrics and Gynecology from Government Medical College, Amritsar in 1991. She has also pursued certificate courses in ART and Clinical Embryology from Manipal University and fellowships in Minimal Access Surgeries. She has also pursued Micromanipulation in ART in the year 2011. Dr. Surveen is practicing at The Fertility Clinic IVF Solutions and Max Super Specialty Hospital. For more information, visit elawoman.com

SOURCES AND REFERENCES:

  1. How to increase sperm count and improve fertility sperm, Elawoman - 2017
  2. Embryo development stages embryo, Elawoman - 2017
  3. How long does sperm live? How Long Does Sperm Live, Elawoman - 2017
  4. What is sperm motility? motility, Elawoman - 2017
  5. When to take pregnancy test? hCG, Elawoman - 2018
  6. What is a normal sperm count for pregnancy? What is Normal Sperm Count for Pregnancy, Elawoman - 2017
  7. How much does ivf cost cost of IVF, Elawoman - 2017
  8. Five things you need to know about fertility treatments Assisted Reproductive Technology, Elawoman - 2017
  9. Imsi is a solution to male infertility IMSI, Elawoman - 2017

6 Comments

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Niraj Prasad

Since my ICSI treatment was failed I lose my hopes but now with this advanced method, I think I should give it a try. Thanks for sharing this article.

Sept. 21, 2018, 3:01 p.m. 5.0

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Kapil Chopra

Our IMSI treatment was successful after 2-3 trials. My wife is pregnant now after one year of our struggle. IMSI treatment indeed proved to be a useful treatment for us.

Sept. 9, 2018, 6:58 p.m. 4.5

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Sheena Bharadwaj

I used to think ICSI and IMSI are the same but there is a significant difference. My doctor suggested me IMSI after 3 failed IVF but I was not convinced at all. Now, after knowing more about IMSI I think it's a good choice.

June 2, 2018, 4:39 p.m. 5.0

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R. Chandrashekhar

After reading this blog, I have realized the importance of IMSI procedure and will surely consider it for our baby planning.

May 24, 2018, 11:08 a.m. 4.5

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Diwakar Chetan

IMSI is an advanced and effective treatment method than the ICSI procedure. Good piece of information. Keep sharing!

March 16, 2018, 2:52 p.m. 4.5

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Shushant Lokhande

Our IVF IMSI treatment was a successful one for us. We achieved success in the first cycle itself.

June 10, 42, 7:42 a.m. 5.0

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