The IMSI -Intra-cytoplasmic morphologically-selected Sperm Injection- also called Super ICSI (since it is a technique that improves the results of intracytoplasmic sperm injection) is a very sophisticated technique of sperm selection. This technique was introduced by Ginefiv pioneering way in 2009
The IMSI allows our biologists select sperm without defects or those with the least disturbance to perform intracytoplasmic sperm injection and, thus, increase rates of implantation and pregnancy. To do this, our biologists employ approximately five times more potent than regular microscope laboratory microscopes in vitro fertilization (getting over 6,000 magnification), being able to examine in detail the sperm and can even observe with intracellular organelles detail such as the vacuole, causing destabilization of the chromatin.
The IMSI can complement the MACS (more information on MACS) for severe male infertility, since the latter selects the sperm without the presence of membrane markers that would indicate any change in the sperm and IMSI makes a selection of which are morphologically better for fertilization.
When is it Indicated?
In principle this technique is designed for any couple is to be subjected to a cycle of Fertilization “In Vitro” with sperm injection, but with a focus on couples with semen samples Oligo-Terato-Astenozoospermicas, and in those patients with previous failures IVF Fertilization “in Vitro”
ICSI is within the technical and IVF is inseminating an egg by a sperm microinjection.
In recent years routinely used in vitro fertilization with intracytoplasmic, also known as ICSI for its acronym in English (Intra Cytoplasmic Sperm Injection).
This technique consists of an egg insemination by sperm microinjection inside. The before and after insemination steps are exactly the same as in a classical in vitro fertilization without ICSI, only changes the insemination technique. To perform the required only ICSI sperm per egg, while a classical IVF are needed without ICSI 50,000 to 100,000. Once fertilized, the egg becomes a pre-embryo and transferred into the uterus to continue its development.
ICSI was developed in 1992 to treat cases of male infertility or sperm abnormalities: azoospermia (absence of sperm), oligozoospermia (low sperm concentration), asthenozoospermia (low motility) or teratozoospermia (low sperm count with proper morphology) and since then it has been a great advance in the treatment of infertility of male origin. Today it is used regularly. Here in Eugin Clinic, we practice ICSI in 99% of cases, unless otherwise indicated.
1. Control and ovarian stimulation
For eggs the ovaries are stimulated by daily administration of hormones for 2 or 3 weeks and is tracked to check hormone levels and development of follicles (egg sacs containers) in the ovaries. When the number and size of follicles is right is determined on the day of the extraction.
2. Egg retrieval and in vitro fertilization
The egg retrieval is done by needle aspiration of the follicles. It is a procedure that requires anesthesia with sedation. Once extracted, stay a few hours and by culture, while semen is prepared to isolate motile sperm. Then the eggs are prepared by removing the outer layer of cells that surround and through intracytoplasmic injection in each sperm is introduced.
The day after the extraction and fertilization of ova know the number of them that have been fertilized. In the next two to three days, these eggs will become fertilized pre-embryos prepared for transfer to the uterus. The day of transfer pre-embryos that have better development property to be transferred is selected. By law can be transferred to three pre-embryos but the average number is usually 2 Preembryos placed in a fine catheter and introduced into the uterus. In the embryo transfer is not required anesthesia. Of pre-embryos transferred, usually only one is implanted, but keep in mind that sometimes it can be implemented more than one, which would lead to a multiple pregnancy.
The frozen pre-embryos not transferred by liquid nitrogen (cryopreservation this is known as vitrification) and subsequently stored in the bank properly identified embryos. These pre-embryos can be used in subsequent cycles if pregnancy is not achieved on the first attempt. Obviously, the treatment to prepare the uterus for a frozen embryo transfer is much simpler because the stimulation and egg retrieval is required.