Which Semen Pathology Correlates with Favorable Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) Outcomes?

Introduction: Intracytoplasmic morphologically selected sperm injection (IMSI), offers selection of motile spermatozoa under high magnification. The benefits of IMSI compared to ICSI have long been a matter of debate, however the benefits of IMSI according to different sperm pathologies were not assessed.

Aim: To assess whether a correlation exists between different sperm pathologies and IMSI outcomes.

Methods and material: A retrospective cohort study which included couples with recurrent implantation failures ( 2 or more unsuccessful IVF-ICSI cycles) undergoing their first IVF-IMSI cycle in Hebrew-University Hadassah Medical Center between January 2008 and May 2017.

Results: A total of 170 couples with at least two IVF failure attempting their first IVF-IMSI cycle were included, of them 56 (32.9%) achieved a clinical pregnancy. No correlation was found between clinical pregnancy and a specific abnormal semen parameter. However, a positive correlation with clinical pregnancy was demonstrated when all three semen parameters were abnormal (OR-3.33, p=0.015).

Conclusions: Our findings suggest that IMSI procedure may be more efficient in severe compound sperm pathologies than in patients with one abnormal sperm parameter. Future prospective trials are required to reinforce these findings and allow formation of clear indications for IMSI.