IMSI (Intracytoplasmic Morphologically Selected Sperm Injection)
IMSI treatment or Intracytoplasmic Morphologically Selected Sperm Injection is similar to but is a slight variation of ICSI treatment. It involves using a technique that helps us to select the ideal sperm that will be used for fertilization. This technique uses a very high-power magnification microscope to visualize inside the sperm. This allows our specialists to select the sperm that have the highest chance of achieving a successful fertilization.
This technique is particularly important in cases of repeated IVF failure where we need to be especially pedantic on which sperm we select for fertilization. For instance in IMSI, we undertake a procedure called sperm DNA fragmentation analysis. DNA fragmentation occurs when there is an alteration or a break in one of the DNA strands inside the sperm itself and this can affect the possibility of a successful pregnancy. Therefore, we analyse sperm with DNA fragmentation analysis so we can identify any samples that contain DNA fragmentation and eliminate them from our selection. At Bedaya hospital we have excellent success rates with IMSI (Intracytoplasmic Morphologically Selected Sperm Injection).
How does IMSI work?
IMSI uses a high-powered light microscope to visualize the sperm up close. The image of the sperm is enhanced by digital imaging in order to magnify the sperm sample more than 6,000 times its normal size. This enables the embryologist to detect problems and subtle structural alterations that a normal microscope would be unable to see. The embryologist selects the sperm that has normally-shaped nuclei and the highest level of motility. This type of sperm is the most successful at fertilization.
Except for this addition step, the rest of IMSI process is very similar to ICSI.
Initially, fertility medication is given to the female to stimulate egg production in the ovaries. Once the follicle in an ovary grows to approximately 17-22 mm, this indicates the eggs have multiplied and are ready to be collected. Approximately 36 hours prior to the egg collection procedure takes place, a hormone called human chorionic gonadotropin (hCG) is injected into the female. The hCG injection is used stimulates the eggs to mature.
The female is given a light sedation and the eggs are collected from the follicles using an ultrasound guided vaginal probe. The probe locates the follicles and collects the contents of the follicle including the eggs and surrounding fluid. The eggs are then placed in culture in our state of the art laboratory. In the laboratory, the embryologists will inject the one of the carefully selected sperm from the IMSI procedure into each egg for fertilization to occur. Once fertilization is successful this creates an embryo that is ready for implantation into the female.
Any remaining good-quality embryos that are not transferred into the female will be frozen and stored. Bedaya Hospital has a very high pregnancy success rate using frozen embryo transfers. The advantage of freezing good quality eggs at this point is that it offers a very high chance of getting pregnant in a subsequent cycle without having to go through the whole IVF procedure again.
IMSI suitable for:
IMSI is usually recommended to couples who have failed IVF cycles in the past, or for couples who have a component of male infertility.
Previous failed IVF cycles, the emotional aspects:
A history of previous repeatedly failed IVF cycles can have a huge impact on couples emotionally, physically and economically, especially when the underlying causes are not clearly identified. At Bedaya, we understand how stressful this can be. We consider each patient individually and discuss the various other treatment options available to you. A thorough review of your previous treatments can better help us manage your case and determine the most appropriate treatment route for you.
We also involve all necessary specialists when reviewing your case such as experienced embryologists, consultants and nurses in order to plan the best treatment course for you. The majority of the time, your outcome for successful treatment can be significantly improved by taking this individualized approach.