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    pink loader
    in vitro fertilisation (ivf)

    IMSI procedure - A solution to male infertility - Advantages, Disadvantages

    • 4.8   (5 Votes)
    Medically Reviewed by Dr. Deepika Tiwari - MS, MBBS on 29 Dec 2018 - Written by Dr. R K Sharma - MD, MBBS - Grammatically Approved by Dr. Kavita Jaggi Agrawal - MS, MBBS

    IMSI procedure is a male infertility treatment solution with advantages such as improving embryo quality, determining fertility, and reducing the chances of miscarriage. IMSI procedure is combined with IVF when infertility specialist finds out that it is required to suffice the treatment results.

    Let’s Discuss in More Detail About IMSI As A Solution To Male Infertility:

    The intracytoplasmic morphologically selected sperm injection (IMSI) is a laboratory technique used for IVF (In Vitro Fertilization treatments). Under this process, high-quality sperms are injected into the egg for fertilization. IMSI was introduced in 2001, and it is an advanced version of ICSI. With the help of a high powered microscope, the best sperm cells are picked out which are used in a traditional ICSI protocol. This method is useful if sperms need to be examined in greater detail, including the nucleus which contains the genetic material of a sperm. IMSI has resulted in lower abortion rates and higher pregnancy and delivery rates. IMSI can be a good option for anyone who has failed IVF cycles in the past or for couples who have male infertility issues. With the IMSI technique, scientists are able to assess the structure of the sperms and exclude the sperms with suspected abnormalities from being injected into the available eggs.

    ivf procedure, ivf treatment

    Cases Where IMSI can be Used

    Achieving a healthy pregnancy is hugely dependent on the quality of the human embryo. The quality of an embryo is a product of the quality of both the egg and the sperm. If sperms have abnormalities, they can still create embryos but these are unlikely to implant or may result in an early miscarriage. Some sperm abnormalities can be identified using a microscope which magnifies up to 400 times. With IMSI the magnification is up to 6000 times, which enables the embryologists to see abnormalities in the head of the sperm with more accuracy. By selecting sperms without abnormalities, the chances of creating better quality embryos are higher.

    IMSI can be used under the following conditions:

    • When there is high levels of DNA fragmentation in the sperm sample
    • If the sperms are susceptible to oxidation damage or poor sperm morphology
    • Repeated abortions or a history of miscarriage
    • When there is more than 90 percent of sperm abnormality
    • If few embryos make it to the blastocyst stage
    • Repeated pregnancy failures despite the transfer of several quality embryos
    • Age of male partners over 40 years
    • Two failed ICSI Cycles (Failed cycles constitutes no pregnancy or first-trimester miscarriage)
    • Three failed IVF cycles
    • Increased levels of sperm aneuploidy
    • If the quality of the egg has seemed to be normal but still there is no implantation
    • Deficiency in the levels of sperms or a high percentage of irregular formed cells.

    Process of IMSI

    IMSI and ICSI require high resolution and high contrast microscopes that are equipped with micromanipulation. The process of IMSI is usually carried out in a petri dish sitting on a heated microscope stage glass insert. Once the best sperm is selected the IMSI procedure is carried out in exactly the same way as ICSI.

    The process of IMSI includes the following step:

    • Firstly eggs are harvested and incubated.
    • Morphological selection of a healthy egg is done with an inverted microscope
    • The oocyte is maintained by a holding pipette and the semen is analyzed with an upright microscope
    • The healthy sperm cell is selected by using an inverted microscope with high magnifications
    • A glass micropipette is used to paralyze the selected sperm by cutting its tail
    • The sperm is directed to the inner part of the oocyte by piercing the oocyte through the membrane.
    • The sperm is then released into the oocyte

    It is important that the cellular structures like the polar body of the egg cell and zona pellucida must be clearly detectable. The shape and vacuole count of the sperm cells must also be assessed.

    process of IMSI

    Advantages of IMSI

    • IMSI method doubles pregnancy rates and lower abortion rate by 60 percent during the first trimester
    • The chance of miscarriage can be reduced by selecting better sperm
    • IMSI facilitates the interaction between spermatozoa and oocyte
    • It bypasses seminal abnormalities like reduced number, motility or increased morphological defects of spermatozoa. 
    • Sperm morphology plays an important role in determining fertility. It is proven to be closely related to fertilization and pregnancy rates in the natural fertilization process
    • Normal sperm morphology is necessary for the successful passage through the zona pellucida and fusion with the plasma membrane of the oocyte
    • IMSI has been related to improving the embryo quality, with a higher percentage of embryos to reach the blastocyst stage

    According to a study it has been found that the success rate of IMSI is 66 percent as against 33 percent in case of a normal sperm Injection. Today, the IMSI procedure has many benefits for men with teratozoospermia, especially in severe cases where most sperms are abnormally shaped.


    IMSI is preferred only when sperm quality is too low or in cases of repeated IVF or IVF with ICSI failure. IMSI has also some disadvantages, which include:

    • IMSI is time-consuming; it adds a considerable amount of extra time to the IVF procedure of about 1.5 to 5 hours.
    • IMSI is expensive, due to its elevated cost; it is not available in most IVF laboratories and clinics.
    • IMSI is more likely to lead to multiple pregnancies in comparison to the ICSI technique.

    IMSI Treatment with IVF

    IMSI can improve significantly the chances of fertilization with IVF and can be used if an IVF cycle has been unsuccessful earlier. The IMSI treatment refers to the procedure of the IVF treatment that is done to examine and select sperm using an inverted microscope that is able to provide more clarity (around 6000 times) than that of normally used microscopes in reproductive laboratories (400 times) to carry out ICSI. An effective selection of sperms without morphological alterations is likely to increase the chances of successful implantation of the pre-embryo and decrease the likelihood of a miscarriage.

    About10 percent of couples are estimated to seek assistance for infertility problems during their reproductive years. Infertility is associated either with male or female infertility problems. The cause of infertility remains unexplained in certain cases or is related to a combination of male and female factors. Assisted reproductive technologies are often considered as the first-line treatment to achieve pregnancy in infertile couples because the underlying conditions can be identified and treated only in a few cases. IMSI is used when the quality of sperms is too poor for conventional IVF to work. IMSI allows almost any man with sperm, either in his semen or in his testis, to try IVF.

    The method of using IMSI still requires more study to demonstrate its efficacy and validity in order to be used routinely in the assisted reproduction laboratory and to be recommended with sufficient scientific evidence.

    You can also find more information on Consult Elawoman for fertility issues. Ela can also recommend various infertility treatment plans to suit your needs. To know more about IMSI with IVF treatment cost and other issues you can call us at +917899912611.

    Dr. R K Sharma

    Written by

    MD, MBBS
    Reproductive Endocrinologist, Hysteroscopic Surgeon

    Dr. R K Sharma is ranked among the best infertility specialist and gynecologists in Delhi. He has treated hundreds of infertile patients and has helped many couples achieve their dream of parenthood. He specializes in Embryo Transfer (ET), Intrauterine insemination (IUI), In Vitro Fertilisation(VF) and Hysteroscopic surgery. He is dedicated to his work and gives his best to achieve success. He is well-versed with the latest technological advancement in medicine. He completed his MBBS from the University of Pune in 1981 and continued to pursue MD in Obstetrics & Gynaecology. He was brilliant in his academics which earned him Membership of Federation of Obstetric and Gynaecological Societies of India (FOGSI). He also provides counseling services to couples who are going for IVF for the first time. He performs the treatments with precision and care to improve the chances of success in the first try. Dr. R K Sharma is the founder and director of ART Centre at Army Hospital (R & R) Delhi and Southern Star ART Centre at Command Hospital (SC), Pune. He is presently practicing at Primus Super Specialty Hospital, Chanakyapuri, Delhi.

    Primus Super Specialty Hospital is a reliable and affordable multispeciality hospital in Delhi. They are serving patients in different specialties like sports physiotherapy, Diagnostic Laboratory, Intrauterine Insemination (IUI), Intra Cytoplasmic Sperm Injection (ICSI), Electrocardiogram (ECG), X-ray, In-Vitro Fertilization (IVF), Blood Test, pregnancy care and women wellness. The hospital follows modern methods of treatment to ensure the utmost comfort and care.


    • Imsi ivf procedure - get to know about imsi infertility treatment  IMSI, Elawoman - 2018
    • Important aspects of ivf which couples must know before opting for the procedure  In Vitro Fertilization treatments, Elawoman - 2017
    • Icsi procedure - why it is done? know about azoospermia treatment  ICSI, Elawoman - 2017
    • Failed ivf cycle! no worries - try 8 easy steps to get success in next ivf cycle  failed IVF cycles, Elawoman - 2019



    Sudheer Gupta

    I never knew about IMSI treatment. Thanks, Ela for sharing this and enlightening us.

    Oct. 10, 2018, 2:21 p.m. 5.0


    Geetika Chawla

    I had a fever for 3 days along with abdominal cramps as a side-effect of IMSI treatment. But it got successful and I am pregnant now.

    Oct. 3, 2018, 5:56 p.m. 4.5


    Sakshi Rudra

    Our IMSI treatment was successful after three failed IVF. Many thanks to the doctors.

    Dec. 14, 2017, 4:03 p.m. 5.0


    Deepti Chopra

    There are women who have conceived with a much longer cycles. You need to follow a proper diet plan and do some kind of exercises. Do have lots of veggies and fresh fruit juices in the diet plan. It will help.

    Nov. 3, 2017, 12:41 p.m. 5.0



    My cycles are 44 days long. Can I get pregnant?

    Aug. 30, 2017, 9:43 a.m. 4.5

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