The European Society of Human Reproduction and Embryology ESHRE reports that approximately 350,000 children are born each year thanks to in vitro. Although in vitro is routinely used to support infertility treatment, specialists are still improving it.
The European Society of Human Reproduction and Embryology ESHRE reports that approximately 350,000 children are born each year thanks to in vitro. Although in vitro is routinely used to support infertility treatment, specialists are still improving it. All this in order to further increase the efficiency of in vitro fertilization. The answer to the question "What should I do to make in vitro more successful?" is IMSI (Intracytoplasmic Morphologically Selected Sperm Injection). IMSI is a variation of ICSI that uses a high power light microscope to magnify the sperm sample over 6000 times. This allows the embryologist to detect subtle structural alterations in sperm that a normal microscope could not detect. Sperm are then selected which have the most normally-shaped nuclei.
Sperm without spot – factor for the development of in vitro technology
Many years of experts experience indicate that it is worth focusing on technologies that make the effectiveness and efficiency of in vitro fertilization increase. Researchers and practitioners focus on optimizing the whole process, the aim of which is to transfer the most valuable sperm to the egg. One that would affect the success of the procedure, i.e. getting pregnant by patients. The goal was defined by the object of researchers - the development of a method that will allow very precise selection of sperm. Embryologists choose for in vitro that sperm that meet strict morphological criteria and thus have better biological potential. This is primarily the hope for those couples who have extremely bad sperm parameters.
The first in vitro fertilization with the IMSI method was performed by a team led by Benjamin Bartoov in Israel- the year 2002. In Poland, in vitro fertilization with the use of this method was first performed in 2006 by two doctors, including Dr. Krzysztof Grettka - a specialist in the treatment of infertility in Gyncentrum.
The difference between IMSI and standard ICSI
The ICSI method (intracytoplasmic sperm injection which is sperm injection into the egg cell) is the standard in the procedures for assisted reproduction. In this method special micropipettes, micromanipulators, and the corresponding inverted microscope are used. A single needle is placed in the middle of the oocyte with a thin needle.
To choose the best, apart from the ICSI, its improved method used - IMSI (intracytoplasmic morphologically selected sperm injection). In this case, one sperm analyzed morphologically under very high magnification is introduced into the egg cell. The biological analysis covers the number and distribution of vacuole in the sperm head. The less they are, the better.
The IMSI test is possible thanks to the use of an optical microscope with a digital imaging path that allows sperm analysis on the monitor screen to be magnified up to 6000 times - many times greater than the usual magnification of about 400 times. During an IMSI, an embryologist beyond the evaluation of the head vacuole can also determine more precisely sperm motility and structure. This is important for the selection of the best male reproductive cell for in vitro fertilization. The sperm head is very important because the nucleus contained in it has genetic material in the form of chromosomes transmitted to children.
In summary, IMSI is a routine procedure for in vitro fertilization - ICSI enriched with the MSOME study, i.e. an additional magnification of sperm cells under a microscope with high optical and digital magnification.
IMSI - from the laboratory
Analysis of morphology and selection of sperm to be fertilized are made immediately before its injection into the egg cell.
In the Gyncentrum Clinic, we use microscopes with the latest MSOME technology (motile sperm organelle morphology examination), which allow sperm analysis at a digital magnification of 6000 times, which enables the selection of the highest quality sperm.
Then, using a micromanipulator, a specially selected, a single sperm is injected directly into the ovum cytoplasm. Fused reproductive cells are placed for 2-3 days in an incubator, in which the conditions imitate the conditions prevailing in the woman's body. After this period, the embryos are ready for embryo transfer.
When is the IMSI method used?
This is a method that is recommended primarily to couples whose attempts at ICSI fertilization ended in failure. IMSI is particularly useful when the malefactor of infertility is found, e.g. fragmentation of sperm DNA, in the case of sperm obtained directly from testes or epididymis during TESE / PESA (testicular and epididymal biopsy). IMSI also works well when other previous semen tests have given unsatisfactory results.
IMSI, due to its precise analytical capabilities, allows couples to avoid the use of a sperm bank in the event that the infertility problem lies with the male.
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