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Intracytoplasmic morphologically selected sperm injection versus intracytoplasmic sperm injection: a step toward a clinical algorithm.
MedLine Citation:
PMID:  23357455     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To study the advantage of intracytoplasmic morphologically selected sperm injection (IMSI) versus intracytoplasmic sperm injection (ICSI) in the first artificial reproductive technology (ART) cycle and in consecutive cycles. DESIGN: A cohort study. SETTING: Single outpatient fertility center. PATIENT(S): Couples presenting with male factor infertility, requiring ovum micromanipulation. INTERVENTION(S): The ICSI or IMSI was performed according to the couple's choice. MAIN OUTCOME MEASURE(S): Clinical intrauterine pregnancies and deliveries. RESULT(S): A total of 1,891 IVF-ICSI cycles and 577 IVF-IMSI cycles were included. In the first IVF treatment, pregnancy rates (PRs) were 46% and 47%, respectively, and delivery rates were 23% versus 30%, respectively. In the second cycle to follow a failed ICSI, PRs and delivery rates were significantly higher for patients who chose to shift to the IMSI technique compared with patients who chose to go through a second IVF-ICSI cycle (56% vs. 38% PRs and 28% vs. 18% delivery rates, respectively). In the following cycles a significant difference was demonstrated in both PR and delivery rates in favor of patients shifting between treatments. In a multivariate analysis an approximate threefold increased chance existed for both pregnancy and delivery only in the case of couples failing an ICSI attempt who shifted to IMSI. CONCLUSION(S): Our present experience supports refraining from repeated IMSI cycles. In light of improved PRs and delivery rates, we recommend promoting the IMSI method for couples who failed ICSI cycle, once or more.
Anat Hershko Klement; Nira Koren-Morag; Pavel Itsykson; Arie Berkovitz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-25
Journal Detail:
Title:  Fertility and sterility     Volume:  -     ISSN:  1556-5653     ISO Abbreviation:  Fertil. Steril.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
The Department of Obstetrics and Gynecology, Meir Medical Center, Kfar-Saba, Israel. Electronic address:
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