IMSI: A Procedure in Assisted Reproductive Technology

IMSI, or Intracytoplasmic Morphologically Selected Sperm Injection, is a procedure often used during IVF to enhance fertilization outcomes. This advanced technique helps doctors distinguish between sperm based on structural quality, allowing them to exclude those with abnormalities. Using a high-magnification digital microscope, sperm are evaluated and selected for injection into the egg.

What is IMSI?

IMSI (Intracytoplasmic Morphologically Selected Sperm Injection) is a specialized technique used alongside IVF to identify and select the best quality sperm. It enables doctors to exclude sperms with structural abnormalities, enhancing the fertilization process and embryo development. The procedure is performed using a high-magnification digital microscope, providing up to 6000x magnification, which allows for more precise selection compared to traditional methods.

Why is IMSI Performed?

IMSI is recommended for cases where IVF with ICSI has resulted in poor outcomes or in instances of severe male infertility. By utilizing higher magnification, embryologists can better identify structurally normal sperm, which increases the likelihood of successful fertilization and embryo development. This technique is especially beneficial for couples who have previously experienced IVF or ICSI failures.

How Does IMSI Work?

IMSI offers a significant advantage over traditional sperm selection methods, which typically magnify sperm by only 400 times. This advanced method allows for magnification up to 6000 times, making it possible to spot even minute structural defects in sperm. Here are the steps involved:

1. A sperm sample is collected and evaluated under a high-powered microscope.

2. The morphology of the sperm is thoroughly examined, and abnormal sperm are excluded.

3. The best-quality sperm are selected for microinjection into the egg.

Who is IMSI Suitable For?

IMSI is particularly beneficial for couples who have experienced repeated IVF or ICSI failures. It is also recommended in cases of severe male infertility, where the percentage of abnormal sperm is high. In these scenarios, IMSI provides a more refined approach to selecting viable sperm for fertilization.

The IMSI Procedure IMSI involves a more detailed sperm selection process than traditional IVF. Embryologists examine sperm under a powerful microscope with digital magnification up to 6000 times. This allows them to exclude sperm with morphological defects and select the healthiest for injection into the egg.

After the selection process, the steps of fertilization proceed similarly to the ICSI method, where the chosen sperm is injected into the egg to facilitate fertilization.

IMSI Treatment Cost In addition to the standard cost of IVF or ICSI treatments, IMSI adds an extra expense. The cost of IMSI in India ranges from ₹1,50,000 to ₹2,76,000. Although IMSI is more expensive than traditional methods, it offers greater precision in sperm selection, which can significantly improve the chances of successful fertilization and pregnancy.

Who is IMSI-IVF Recommended For? IMSI is often recommended for:

• Men with a high percentage of abnormal sperm.

• Couples with failed IVF or ICSI cycles.

• Men with low sperm counts, even in normal samples.

• Those who require surgically retrieved sperm.

It is also beneficial for women who have experienced:

• Repeated failed IVF cycles.

• Miscarriages or recurrent pregnancy losses.

• A lack of implantation despite good-quality eggs.

Risks Associated with IMSI-IVF IMSI is still a relatively new technique and may not be available in all IVF laboratories. It is more time-consuming than traditional IVF, taking an additional 1.5 to 5 hours per cycle. While IMSI increases the chances of success, it also raises the likelihood of multiple pregnancies compared to ICSI.

Pros and Cons of IMSI The success rate for IMSI is around 66%, which is significantly higher than traditional ICSI. Some key advantages include:

• Doubling pregnancy rates while reducing the chance of miscarriage.

• Improved sperm selection, leading to lower risks of miscarriage.

However, there are some downsides:

• IMSI is more expensive and time-consuming.

• There is an increased risk of multiple pregnancies compared to ICSI.

Success Rate of IMSI IMSI has shown significant improvements in pregnancy rates, particularly for men with severe infertility. For couples who have faced multiple failed IVF-ICSI cycles or have unexplained infertility, IMSI has increased the chances of success, improving pregnancy rates from 30% to 60%.

As the technique evolves, it holds promise for becoming even more effective in addressing severe infertility issues in the future.