IMSI as a Valuable Tool for Sperm Selection During ART

  • Monica Antinori
  • Pierre Vanderzwalmen
  • Yona Barak


Conventional semen parameters, routinely used by clinicians to assess male reproductive potential, provide little information on the real fertility status. Nevertheless, sperm morphology analyzed by strict criteria has demonstrated its prognostic value regarding the outcome of both in vivo and in vitro reproduction. However, ICSI introduction seemed to have decreased the importance of sperm morphology in assisted reproduction, since fertilization, embryo development, pregnancies, and healthy deliveries can be achieved even in case of severe morphological impairments. This visual assessment of sperm morphology, due to the limitations attributable to its low magnification (200–400×) and concomitant low resolution, overlooks minor morphologic defects potentially related to increased risk of chromosomal abnormalities in infants conceived with ICSI and decreased success rates. Thus, based on the theory that subtle sperm morphological malformations might remain unnoticed during the routine sperm selection performed prior to microinjection, negatively affecting its outcome, a new technique, termed motile sperm organellar morphology examination (MSOME), has been recently developed to perform a real-time detailed morphological evaluation of motile spermatozoa under 6,600× high magnification. When applied immediately prior the conventional ICSI technique, this new method of sperm morphological selection is defined: intracytoplasmic morphologically selected sperm injection (IMSI).

Even though a rising number of studies have reported IMSI as having remarkable clinical advantages in terms of fertilization, embryo quality, pregnancy occurrence, and prosecution until delivery, this new method continues to be debated regarding its routine application in the ART laboratory. Although IMSI has not yet been standardized and requires further validation, it can be considered one of the most promising issues in the ART field. IMSI has been introduced to increase ART success in overcoming severe male infertility.


Sperm morphology High magnification Selection MSOME IMSI Embryo quality 


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Monica Antinori
    • 1
  • Pierre Vanderzwalmen
  • Yona Barak
  1. 1.Infertility UnitRAPRUI Day HospitalRomeItaly

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