Infertility is a serious problem that affects many couples around the world. IVF treatment has become a beacon of hope for those who cannot have babies with natural methods or medicinal treatments. However, if multiple unsuccessful attempts in IVF performed with classical methods are encountered, procedures to support IVF treatment are needed.

In some cases of infertility, such as unexplained infertility, IVF treatment is usually successful in the first attempt. Unfortunately, there are other factors that affect a woman’s chances of conception in most cases. At least 30% to 35% of the causes of infertility depends on the male factor. In such cases, the most effective result will be to choose the healthiest sperm. The “intracytoplasmic morphologically selected sperm injection” method known as IMSI is an effective technique for sperm-derived infertility.

What is IMSI?

Male infertility is determined by an analysis of a sperm sample. Sperm is tested for its motility, morphology, and quantity. Abnormal results in any of these parameters may cause fertility problems. Physicians may recommend microinjection, intrauterine insemination, or IVF treatments depending on the severity of the problem. In the microinjection method, the success rate is high because sperm are injected individually into egg cells. However, since the quality level of randomly selected sperm is not known, it is also highly likely to encounter negative results.

The IMSI technique developed by Professor Bartoov in 2002 enabled a detailed examination of sperm. Since this method enables fertility treatments to be performed with the healthiest sperm, it allows the highest pregnancy rates.

In the IMSI method, a high-power microscope developed by digital imaging is used to analyze the ultrastructures of the sperm. Embryologists can thus choose optimally high-quality sperm with no defects. The microscope used in the IMSI technique has 6000 to 12000x greater magnification power than conventional microscopes that provide 400x magnification. Even the nucleus can be analyzed for the presence of structural deformities and vacuoles (small bubbles) in sperm. Sperm analysis involves the observation of morphological properties. Once high-quality sperm is selected, the rest of the process continues in the same way as a normal microinjection procedure.

Who is eligible for IMSI?

The IMSI procedure can generally be applied in the following cases:

• Male, older than 35 years of age,
• The presence of abnormal sperm in semen analysis,
• Low sperm count,
• High levels of DNA fragmentation in sperm,
• Having negative results in previous treatments such as intrauterine insemination, microinjection, IVF, etc.
• Recurrent miscarriages,
• Failure to achieve conception despite the transfer of some reasonably quality embryos,
• For couples who did not obtain good quality embryos in previous cycles, even though egg quality appears normal.

As a result of detailed examinations of individuals who are admitted with infertility problems to be performed by specialist physicians in the health center, whether the IMSI method is appropriate should be determined.

What are the advantages of the IMSI method?

Achieving a healthy pregnancy depends largely on the quality of the human embryo. The quality of an embryo is directly related to the quality of the egg and the quality of the sperm that fertilizes the egg. Many sperm and eggs have abnormalities that can form an embryo that is unlikely to settle in the uterus and become a successful pregnancy.

Upon IMSI, embryologists are allowed to observe any abnormalities in the sperm head. By selecting sperm without abnormalities, it becomes possible to form a better-quality embryo.

The rates of conception as a result of IMSI are quite high. Thus, the cost of fertility treatments such as IVF or intrauterine insemination, which is received multiple times, is minimized. In addition, the probability of undesirable consequences such as miscarriage during pregnancy is also reduced as higher quality embryos will be obtained.