Human sperm head vacuoles are physiological structures formed during the sperm development and maturation process

Purpose To compare the outcomes of ICSI and IMSI in women presenting with poor ovarian response. Methods Data of IMSI cycles performed from January 2011 to December 2013 were included in this retrospective cohort study. Patients were divided into two groups: normoresponder patients (NR group; patients with>4 oocytes retrieved) and poor-responder patients (PR group; patients with≤4 oocytes retrieved). Patients who underwent IMSI were matched with patients who underwent ICSI in the same period. The ICSI and IMSI outcomes were compared in the NR and PR groups. Results A total of 414 matched cycles were included in this study. The NR group comprised 324 cycles (164 ICSI and 160 IMSI cycles), and the PR group comprised 90 cycles (43 ICSI and 47 IMSI cycles). In the NR group, no significant differences were observed between the ICSI-and IMSI-treated couples regarding cycle outcomes. In the PR group, fertilisation rate was significantly lower in IMSI-treated couples (53.9 %± 36.7 % vs. 79.8 %±29.3 %). The proportion of cycles with embryo transfer (57.4 vs. 79.1 %) and the number of transferred embryos (1.5±0.8 vs. 1.9±0.7) were significantly lower in IMSI compared with ICSI. Implantation, pregnancy and miscarriage rates were similar when ICSI or IMSI were performed. Conclusions Our results suggest that unselected couples undergoing ICSI that present with poor ovarian response to controlled ovarian stimulation do not benefit from sperm selection under high magnification prior to ICSI.

Section: Discussionmentioning

confidence: 99%

Poor-responder patients do not benefit from intracytoplasmic morphologically selected sperm injection

Setti

Braga

Figueira

et al. 2015

“…Although the origin of these vacuoles raises many questions, some strong correlations have been established between the morphology of the spermatozoon, in particular the presence of large vacuoles, and its nuclear quality (degree of chromatin condensation and/or DNA integrity, chromosomal content) [8]. However, the high frequency of sperm head vacuoles in fertile men highlights the physiological nature of some of these vacuoles [9,10]. The observation of sperm head vacuoles is used to select spermatozoa before microinjection: intracytoplasmic morphologically selected sperm injection (IMSI).…”

Section: Introductionmentioning

confidence: 99%

Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve outcome in patients with two successive IVF-ICSI failures

Gatimel

Parinaud

Léandri

2016

Purpose Assessment of sperm morphology has been reconsidered since 2001 with the development of motile sperm organelle morphology examination (MSOME). This observation technique that combines high magnification microscopy and the Nomarski interference contrast makes it possible to select spermatozoa with as few vacuoles as possible before microinjection into the oocyte (intracytoplasmic morphologically selected sperm injection, IMSI). More than 10 years after the development of IMSI, the indications of the IMSI technique and its ability to increase pregnancy and/ or birthrates (compared with conventional ICSI) are still subject to debate. We aimed to better define the interest of IMSI in the third attempt. Methods We assessed the benefit of IMSI by carrying out a retrospective comparative study between IMSI and conventional ICSI during a third ART attempt. Two hundred sixteen couples with two previous ICSI failures were studied between February 2010 and June 2014. Results IMSI did not significantly improve the clinical outcomes compared with ICSI, either for implantation (12 vs 10 %), clinical pregnancy (23 vs 21 %), or live birth rates (20 vs 19 %).Conclusion This study provides supplementary arguments for not achieving IMSI procedure in the third attempt after two previous ICSI failures.

“…The sperm vacuole is a concavity extending from the surface of the sperm head to the nucleus through the acrosome [5]. It has been suggested that sperm vacuoles should be regarded as normal features of the sperm head that occur naturally during the process of condensation of sperm nuclei, and should not be regarded as degeneration but as physiological changes that do not compromise the sperm quality [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…It has been suggested that sperm vacuoles should be regarded as normal features of the sperm head that occur naturally during the process of condensation of sperm nuclei, and should not be regarded as degeneration but as physiological changes that do not compromise the sperm quality [5,6]. Meanwhile, studies suggest that the presence of sperm vacuoles is related to male sub fertility [7], lower mitochondrial membrane potential [8], higher incidence of chromosomal abnormalities [8,9], and sperm chromatin packaging/DNA abnormalities [1,4,6,[10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

The prevalence of sperm with large nuclear vacuoles is a prognostic tool in the prediction of ICSI success

Setti

Braga

Vingris

et al. 2013

Purpose To investigate if there is a correlation between the prevalence of sperm with large nuclear vacuoles (LNV) and intracytoplasmic sperm injection (ICSI) outcomes. Methods Two hundred male patients undergoing ICSI had their sperm morphology evaluated through motile sperm organelle morphology examination (MSOME) and the percentage of LNV sperm was recorded and correlated to the ICSI outcomes.Results The percentage of sperm with LNV negatively influenced the blastocyst formation (S: 16.9, R 2 : 20.5 %, p=0.004) and implantation (S: 34.7, R 2 : 26.2 %, p=0.001). There were significant differences in the percentage of sperm with LNV between patients in which pregnancy was achieved or not (22.2 % vs. 28.4 %, p<0.001) and in patients with ongoing pregnancy or not (22.4 % vs. 28.5 %, p<0.001). The incidence of sperm with LNV was determinant to the decreased odds of pregnancy (OR: 0.74, p<0.001) and increased odds of miscarriage (OR: 1.46, p<0.001). The area under the curve (AUC) was sufficient to distinguish between couples which did achieve pregnancy or not (AUC: 0.922, p<0.001).Conclusions The MSOME is a prognostic tool in the prediction of ICSI success and could be used to select patients that should have their sperm selected by MSOME for ICSI.