González-Ortega C, Cancino-Villarreal P, Pérez-Torres A, Vargas-Maciel MA, Martínez-Garza SG, Pérez-Peña E, Gutiérrez-Gutiérrez AM

Language: Spanish
References: 19
Page: 652-659
PDF size: 376.14 Kb.

ABSTRACT

Background: Intracytoplasmic sperm injection (ICSI) is highly effective for the control of male factor infertility. The sperm selected for ICSI may have structural abnormalities undetectable to 400x as nuclear vacuoles, decreasing rates of pregnancy and implantation. Recent studies show that with intracytoplasmic morphologically selected sperm injection (IMSI), at higher magnification (> 6,600x), increases pregnancy and implantation rates in patients with repeated failure to ICSI.
Objective: To compare the results of the injection of selected motile sperm organelle morphology examination (MSOME) for IMSI, instead of the use of ICSI in patients with repeated failure to ICSI.
Patients and method: Prospective, observational cohort study. Since February 1, 2010 was administered IMSI to couples with at least two failed cycles of ICSI, and analyzed the first 30 cycles in patients under 38 years of good ovarian reserve. This study group was compared with the last 30 cycles of ICSI performed before that date, in patients with similar clinical characteristics. The IMSI was performed with a magnification of 7,676 increases for evaluation and sperm selection.
Results: The groups had similar clinical characteristics. The pregnancy rate with IMSI was better than with ICSI (63 vs. 50%), the difference was not significant for the size of the sample, although the trend is clear and clinically significant in favor to IMSI. The implantation rate with IMSI (44.8%) showed statistically significant differences vs. ICSI (29.7%). No significant differences in abortion rates.
Conclusions: IMSI significantly improves the implantation rate in patients with repeated failure to ICSI.

REFERENCES

1. De Vos A, Van De Velde H, Joris H, Verheyen G, et al. Influence of individual sperm morphology on fertilization, embryo morphology, and outcome of intracytoplasmic sperm injection. Fertil Steril 2003;79:42-48.

2. World Health Organization. WHO laboratory manual for the examination and processing of human semen. 5th ed. WHO Press, 2010.

3. Kruger TF, Acosta AA, Simmons KF, et al. Predictive value of sperm morphology in in vitro fertilization. Fertil Steril 1998;49:112-117.

4. Liu DY, Baker HW. High frequency of defective sperm-zona pellucid interaction in oligozoospermic infertile men. Hum Reprod 2004;19:228-233.

5. Palermo G, Joris H, Devroey P, et al. Pregnancies after intracytoplasmic injection of single spermatozoon into an oocyte. Lancet 1992;340:17.

6. Bartoov B, Berkovitz A, Eltes F, et al. Real-time fine morphology of motile human sperm cells is associated with IVF-ICSI outcome. J Androl 2002;23:1-8.

7. Bartoov B, Berkovitz A, Eltes F, et al. Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection. Fertil Steril 2003;80:1413-1419.

8. Hazout A, Dumont-Hassan M, Junca AM, et al. High magnification ICSI overcomes paternal effect resistant to conventional ICSI. RBM Online 2006;12:19-25.

9. Gutiérrez GAM, González OC, Cancino VP, Tovar CG y col. Micromanipulación de gametos. En: Delgado UJ, Fernández del Castillo C. Ginecología y Reproducción Humana. Temas selectos. Colegio Mexicano de Especialistas en Ginecología y Obstetricia, 2006;p:46,381-393.

10. Barth AD, Oko RJ. Defects of the sperm head. In: Barth AD, Oko RJ, editors. Abnormal morphology of bovine spermatozoa. IS lowa State University Press, Ames, 1988;p:130-192.

11. Bartoov B, Eltes F, Pansky M. Improved diagnosis of male infertility potencial a combination of quantitative ultramorphology and routine semen analyses. Hum Reprod 1994;9:2069- 2075.

12. Berkovitz A, Eltes F, Yaari S, et al. The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm. Hum Reprod 2005;20:185-190.

13. Berkovitz A, Eltes F, Ellenbogen A, et al. Does the presence of nuclear vacuoles in human sperm selected for ICSI affect pregnancy outcome? Hum Reprod 2006;21:1787-1790.

14. Franco Jr JG, Baruffi RLR, Mauri AL, et al. Significance of large nuclear vacuoles in human spermatozoa: Implications for ICSI. RBM Online 2008;17:42-45.

15. Antinori M, Licata E, et al. Intracytoplasmic morphologically selected sperm injection: a prospective randomized trial. RBM Online 2007;6:835-841.

16. Mauri A, Petersen C, et al. Comparison of day 2 embryo quality after conventional ICSI versus intracytoplasmic morphologically selected injection (IMSI) using sibling oocytes. Europ J Obst Gynec Reprod Biol 2010;150:42-46.

17. Garolla A, Fortín D, Menegazzo M, et al. High power microscopy for selecting spermatozoa for ICSI by physiological status. RBM Online 2008;17:610-616.

18. Hazout A, Dumont-Hassan M, Junca AM, et al. High magnification ICSI overcomes paternal effect resistant to conventional ICSI. RBM Online 2006;12:19-25.

19. Bartoov B, Berkovitz A, Eltes F. Pregnancy rates are higher with Intracytoplasmic morphologically selected sperm injection the convencional intracytoplasmic injection. Hum Reprod 2003;806:1413-1418.