Live birth and miscarriage rate following intracytoplasmic morphologically selected sperm injection vs intracytoplasmic sperm injection: An updated systematic review and meta‐analysis

Durán-Retamal, Montserrat; Morris, Guy; Achilli, Chiara; Gaunt, Matthew; Theodorou, Efstathios; Saab, Wael; Serhal, Paul; Seshadri, Srividya

doi:10.1111/aogs.13703

Cited by 20 publications

(9 citation statements)

References 44 publications

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“…Recently, high-powered differential interference contrast optics provided a novel means to improve the selection of morphologically superior spermatozoa under ultra-high magnification of Â10,160: intracytoplasmic morphologically selected sperm injection (IMSI). Notwithstanding some reports of increased success, a recent metaanalysis of randomized studies comparing IMSI and ICSI has not shown a difference in live birth or miscarriage rate (143). A bibliographic analysis revealed consensus for the following findings: 1) head sperm vacuoles appear frequently, often multiple and preferentially anterior; 2) sperm vacuoles and sperm chromatin immaturity are related; and 3) teratozoospermia could be a preferred indication of IMSI (144).…”

Section: Intracytoplasmic Sperm Injectionmentioning

confidence: 99%

Sperm morphology and its disorders in the context of infertility

Oehninger

Kruger

2021

F&S Reviews

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This manuscript reviews sperm morphology and its disorders in the context of infertility. A new look into an old challenge is delivered, based on contemporary scientific and clinical evidence. We highlight the functional repercussions of sperm morphology aberrations and dissect the cause and effect of a variety of insults and pathogenic mechanisms focusing on the relationships among sperm shape, function, and compartmental analysis of cellular and subcellular structures. Different types of teratozoospermia are identified as a sequela of aberrant spermiogenesis, and their proven or speculated origins are discussed. In addition to known and suspected genetic causes, oxidative damage is highlighted as a major plausible pathogenic factor. The examination of sperm morphology with the use of strict criteria provides valuable information to guide the clinician to direct therapeutic management. We emphasize that sperm morphology is probably the most relevant parameter of the traditional semen evaluation and can be used as a valid biomarker of functional deficiencies, providing information about chances of conception. The information provided by the examination of sperm morphology as part of a complete semen analysis becomes more and more significant from a clinical point of view for infertility and perhaps men's health. (Fertil Steril Rev Ò 2021;2:75-92. Ó2020 by American Society for Reproductive Medicine.

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Section: Intracytoplasmic Sperm Injectionmentioning

confidence: 99%

Sperm morphology and its disorders in the context of infertility

Oehninger

Kruger

2021

F&S Reviews

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“…IMSI is one of the sperm selection techniques used in assisted reproduction, with application indicated for cases of male factor infertility and failed ICSI. IMSI includes strict sperm morphological investigation performed under magnifications of 6600-10000x and reportedly improves clinical and perinatal outcomes (Duran-Retamal et al, 2020). The use of MSOME for sperm selection before ICSI has been discussed by several authors regarding the improvement of clinical results including clinical pregnancy and live birth rates; however, trials rarely provide information on perinatal information (Antinori et al, 2008;Marci et al, 2013;Gatimel et al, 2016;He et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

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

Dieamant

Petersen

Vagnini

et al. 2021

JBRA

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Objective: It is generally accepted that the incidence of birth defects in spontaneously conceived children ranges between 2.0-4.0%. However, several studies have shown that babies born after assisted reproductive technology (ART) procedures tend to present more congenital malformations than naturally conceived children, with 6.5% of the children born after intracytoplasmic sperm injection (ICSI) presenting birth defects. The use of high magnification sperm selection before ICSI was introduced in the early 2000s to allow the identification of spermatozoa with low risk of sperm DNA damage. Intracytoplasmic morphologically selected sperm injection (IMSI) is expected to change the incidence of congenital malformations, although data on the incidence of birth defects in children conceived after IMSI are still scarce.Methods: A systematic review based on searches performed in electronic databases (PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials) including articles published by February 2021 was conducted to identify trials comparing the neonatal outcomes of ICSI and IMSI. The outcome measured was the rate of birth defects in children born after ICSI or IMSI. Three trials were included as targets for data extraction and meta-analysis. Results: Our meta-analysis included 3907 children conceived after IMSI (1280) or ICSI (2627). The incidence of birth defects was statistically different, with 2.5% (32/1280) in IMSI and 4.5% (119/2627) in ICSI (RR=0.59; 95% CI=0.40-0.87; p=0.007). The results demonstrated that IMSI decreased the incidence of structural defects compared to ICSI -2.2% (18/830) vs. 3.8% (78/2049) -in a statistically significant manner (RR=0.58; 95%CI=0.35-0.96; p=0.04). No significant difference was observed in chromosomal abnormalities (Trisomy 13; 18; 21 and Triple X) between children conceived after IMSI (8/830) or ICSI (19/2049) (RR=1.07; 95%CI=0.47-2.43; p=0.87).Conclusions: IMSI seems to be an effective tool at reducing the incidence of structural defects compared to ICSI. However, IMSI does not change the incidence of chromosomal abnormalities.

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“…Contrarily, a meta‐analysis conducted by Teixeira and colleagues indicated that nine randomised controlled trials (RCTs) exhibited no supporting evidence for the effectiveness of IMSI routine clinical use (Teixeira et al., 2013). Such findings are further justified by the up‐to‐date Cochran review (Teixeira et al., 2020), and the latest meta‐analysis study involving six RCTs (Duran‐Retamal et al., 2020). The potential benefits of IMSI practice remain inconclusive.…”

Section: Introductionmentioning

confidence: 95%

Morphokinetics of embryos after IMSI versus ICSI in couples with sub‐optimal sperm quality: A time‐lapse study

Boediono

Handayani²,

Sari³

et al. 2021

Andrologia

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An investigation was conducted to determine the influence of two sperm selection modalities, IMSI and ICSI, on the morphokinetics, dynamic development and ploidy status of embryos derived from males with sub‐optimal sperm profiles during IVF program. A total of 209 PGTA‐tested top‐quality blastocysts (IMSI = 129, ICSI = 80) from 84 couples (IMSI = 51, ICSI = 33) were assessed retrospectively. This study found that both IMSI and ICSI yielded comparable embryo morphokinetics, except for the T7, TEB and CC3 parameters (p < 0.05). A significant lower incidence of multinucleation was observed in the IMSI group when compared to the ICSI group (48.8% vs. 71.3%, p = 0.002), while other parameters of embryo development such as direct cleavage, distorted cytoplasmic movement, reverse cleavage and vacuole(s) appearance did not differ (p > 0.05). No differences were noticed in the proportion of generating chromosomally euploid embryos (44.2% vs. 51.3%, p = 0.394, respectively, for IMSI and ICSI). The implementation of IMSI or ICSI in couples with sub‐optimal sperm profiles resulted in embryos with comparatively similar morphokinetics. Furthermore, the incidence of multinucleation at the two‐ to four‐cell stage was lower following the practice of IMSI, although the method did not improve the proportion of gaining euploid embryos.

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Live birth and miscarriage rate following intracytoplasmic morphologically selected sperm injection vs intracytoplasmic sperm injection: An updated systematic review and meta‐analysis

Cited by 20 publications

References 44 publications

Sperm morphology and its disorders in the context of infertility

Sperm morphology and its disorders in the context of infertility

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

Morphokinetics of embryos after IMSI versus ICSI in couples with sub‐optimal sperm quality: A time‐lapse study

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