| Popis: |
Intracytoplasmic sperm injection (ICSI) is the recommended treatment in many cases of male factor infertility. Introduced in 2001, the intracytoplasmic morphologically selected sperm injection (IMSI) procedure changed the perception of how a spermatozoon suitable for injection should be selected. Sperm selection is carried out at ×6000 magnification (motile sperm organelle morphology examination or MSOME), allowing improved assessment of the sperm nucleus. By the selection under high magnification, the spermatozoa can be evaluated for fine integrity of its nucleus and the injection of a normal spermatozoon with a vacuole-free head can be assured. Several comparative studies have indicated that the use of MSOME for sperm selection was associated with both higher pregnancy and delivery rates, whereas also lower miscarriage rates were observed. However, randomized and well-powered studies to confirm these findings are scarce and show conflicting results. Therefore, the most relevant indications for IMSI still remain to be determined. |
