Review Article
Wilding M, Coppola G, Faboz
Abstract
Study Background: Intracytoplasmic morphology-selected sperm injection (IMSI) is a procedure in which spermatozoa are digitally analysed prior to injection into the oocyte. This increases the chance of selecting a good sperm, but physiological selection is not carried out. Here, we combine physiological pre-selection of spermatozoa with IMSI for patients with idiopathic infertility. Methods: 290 patients, attending for assisted reproduction, were prepared for oocyte retrieval using standard controlled ovarian hyperstimulation protocols. Spermatozoa were preselected for ICSI with either digitalised morphological selection (IMSI) or IMSI combined with hyaluronic acid (HA) pre-selection techniques (pIMSI). Biological and clinical parameters were recorded and the clinical pregnancy rate noted. Results: HA- pre-selection of mature spermatozoa led to a significant increase in pregnancy and implantation rates in patients treated with IMSI. Conclusions: These data suggest that the combination of HA pre-determination of spermatozoa and advanced morphological analysis enables sperm selection on both a physiological and morphological basis and increases the probability of selecting a high quality spermatozoa.\r\n