Impact of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) on Birth Defects: A Systematic Review and Meta-Analysis

Dieamant, Felipe; Petersen, Claudia G.; Vagnini, L.D.; Renzi, Adriana; Petersen, B.; Massaro, Fabiana C.; Zamara, Camila; Nicoletti, A.; Ricci, Juliana; Oliani, António Hélio; Oliveira, J.B.A.; Franco, J.G.

doi:10.5935/1518-0557.20210030

Cited by 4 publications

(4 citation statements)

References 37 publications

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“…Numerous discrepancies exist in the literature, notably concerning IMSI effectiveness compared to ICSI, in improving ART results (fertilization / clinical pregnancy / live births rates / miscarriage). However, a recent systematic review and meta-analysis of an average of 4,000 live births with congenital anomalies after IMSI concluded that this technique appears to be an effective tool for reducing the incidence of structural anomalies compared to ICSI [ 59 ]. On the other hand, IMSI was shown not to alter the incidence of chromosomal anomalies i.e.…”

Section: Discussionmentioning

confidence: 99%

First-line infertility treatment in normal or subnormal sperm: Interest of a simplified pre-IMSI test

Sigala,

Poirey,

Robert

et al. 2024

PLoS ONE

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Background In the field of male infertility, when sperm is normal/subnormal, a few “add-on” routine tests can complete the basic semen examination. Objectives The aim of this study was to develop and evaluate a faster, simplified motile sperm organelle morphology examination (MSOME) technique for selected infertile patients with apparently normal/subnormal sperm and, in their background: failure of two or three intrauterine insemination (IUI) cycles, repeatedly fragmented embryos, embryonic development to blastocyst-stage failures, repeated miscarriages, a long period of infertility or 2 or more IVF attempts without pregnancy. Our test results were correlated with IUI, conventional in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and intracytoplasmic morphologically selected sperm injection (IMSI) outcomes. Materials and methods We validated an adapted version of the MSOME analysis called the pre-IMSI test (PIT), based on vacuole evaluation alone. 248 infertile patients from our assisted reproductive technology (ART) Center were retrospectively selected and split into three PIT score subgroups (patients with ≤8% (score I), 9 to 15% (score II) and ≥16% normal spermatozoa (score III)) based on the correlation between PIT results and each ART technique outcome. The choice of one or another of these ART techniques had been made according to the usual clinico-biological criteria. Results Clinical outcomes for each of the three PIT subgroups were compared individually for the different ART techniques. For ICSI, the effect of the PIT score subgroup was significant for clinical pregnancies (p = 0.0054) and presented a trend for live births (p = 0.0614). Miscarriage rates of IVF attempts were statistically different depending on the PIT score (p = 0.0348). Furthermore, the odds ratios of clinical pregnancy rates were significantly different according to PIT score subgroup when comparing ICSI vs. IMSI or IVF vs. ICSI attempts. Discussion IMSI appears to be recommended when sperm belongs to PIT score I, ICSI when it belongs to PIT score II and IVF or IUI when sperm is of PIT score III quality in selected infertile couples. The lack of statistical power in these PIT subgroups means that we must remain cautious in interpreting results. Conclusion Our results support the interest of this simplified test for certain couples with normal/subnormal sperm to help choose the most efficient ART technique, even as first-line treatment.

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Section: Discussionmentioning

confidence: 99%

First-line infertility treatment in normal or subnormal sperm: Interest of a simplified pre-IMSI test

Sigala,

Poirey,

Robert

et al. 2024

PLoS ONE

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“…The method was promising but the results were conflicting ( 87 ). Recently, Dieamant et al ( 88 ), revising the literature, found that IMSI appeared to be an effective procedure in reducing the congenital malformations in newborns compared to ICSI.…”

Section: Impact Of Sperm Morphology In Assisted Fertilizationmentioning

confidence: 99%

The relevance of sperm morphology in male infertility

Moretti

Signorini

Noto

et al. 2022

Front. Reprod. Health

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This brief report concerns the role of human sperm morphology assessment in different fields of male infertility: basic research, genetics, assisted reproduction technologies, oxidative stress. One of the best methods in studying sperm morphology is transmission electron microscopy (TEM) that enables defining the concept of sperm pathology and classifying alterations in non-systematic and systematic. Non-systematic sperm defects affect head and tail in variable ratio, whereas the rare systematic defects are characterized by a particular anomaly that marks most sperm of an ejaculate. TEM analysis and fluorescence in situ hybridization represent outstanding methods in the study of sperm morphology and cytogenetic in patients with altered karyotype characterizing their semen quality before intracytoplasmic sperm injection. In recent years, the genetic investigations on systematic sperm defects, made extraordinary progress identifying candidate genes whose mutations induce morphological sperm anomalies. The question if sperm morphology has an impact on assisted fertilization outcome is debated. Nowadays, oxidative stress represents one of the most important causes of altered sperm morphology and function and can be analyzed from two points of view: 1) spermatozoa with cytoplasmic residue produce reactive oxygen species, 2) the pathologies with inflammatory/oxidative stress background cause morphological alterations. Finally, sperm morphology is also considered an important endpoint in in vitro experiments where toxic substances, drugs, antioxidants are tested. We think that the field of sperm morphology is far from being exhausted and needs other research. This parameter can be still considered a valuable indicator of sperm dysfunction both in basic and clinical research.

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“…Still, uncertainty remains over whether the selection process can definitively eliminate all genetic defects in sperm within a group with highly abnormal semen parameters, especially in cases of severe oligoteratozoospermia (i.e., low sperm count and motility) [6]. Although some studies have proposed intracytoplasmic morphologically selected sperm injection (IMSI) to select the best sperm to achieve optimal pregnancy outcomes, this technique is still under investigation [7]. Many genetic factors have been implicated in male infertility, and prior studies have consistently demonstrated that individuals experiencing severe oligozoospermia (i.e., low sperm count) and teratozoospermia (i.e., abnormal sperm forms) have a higher incidence of sperm aneuploidy than those with normal semen parameters [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Chromosomal analysis of single sperm cells from infertile couples with severe oligoteratozoospermia: A cross-sectional prospective study

Sassanarakkit,

Chamnankran,

Singwongsa

et al. 2024

PLoS ONE

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In this cross-sectional prospective study, advanced next-generation sequencing technology was used to compare the molecular karyotyping of individual human sperm cells in infertile couples with severe oligoteratozoospermia (i.e., low sperm count and motility) to those of infertile couples with normal semen. Fourteen infertile couples who were patients at Ramathibodi Hospital in Bangkok, Thailand, were recruited from January to November 2023, and they were categorized into two groups based on semen analysis results. The study group comprised couples with severe oligoteratozoospermia, whereas the control group exhibited normal semen. Individual sperm cells from the semen samples were isolated by the micromanipulation technique for subsequent whole-genome amplification and next-generation sequencing, where the primary outcome was the aneuploidy rate. Seventy individual sperm cells were isolated with a 90% success rate for amplification. The next-generation sequencing results showed that the aneuploidy rate was 25%–75%, with a mean of 48.28% in the study group. In contrast, the control group exhibited aneuploidy rates of 0–75%, with a mean of 15.15%. The difference between the two groups was statistically significant (odds ratio: 5.8, 95% confidence interval: 1.30–26.03). Sperm cells of the study group showed a threefold higher aneuploidy rate than those in the control group, even though the sperm cells were selected by micromanipulation for their normal morphology. Comprehensive counseling is recommended to address elevated aneuploidy rates that potentially surpass those of the general infertile population. Guidance on preimplantation genetic testing is also recommended to ensure the transfer of embryos with normal chromosomes.

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Impact of Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) on Birth Defects: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 37 publications

First-line infertility treatment in normal or subnormal sperm: Interest of a simplified pre-IMSI test

First-line infertility treatment in normal or subnormal sperm: Interest of a simplified pre-IMSI test

The relevance of sperm morphology in male infertility

Chromosomal analysis of single sperm cells from infertile couples with severe oligoteratozoospermia: A cross-sectional prospective study

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