IMSI Method

ICSI with Morphologically Selected Sperm

Intrauterine (Intracytoplasmic Morphologically Selected Sperm Injection) —in other words, the intracytoplasmic injection of a morphologically selected sperm cell into an egg—is a more advanced variation of ICSI, in which a single sperm cell is injected directly into the egg.

The distinguishing feature of IMSI is the examination of sperm at very high magnification—approximately ×6,000—using a specialised high-resolution microscope. This allows the embryologist to assess the sperm head and internal morphology in greater detail than is possible during standard ICSI. The technique enables a highly detailed assessment of sperm morphology and supports the selection of sperm with the most favourable visible characteristics before ICSI.

It remains uncertain whether IMSI is beneficial in every case requiring ICSI. It may be considered for patients with a history of repeated unsuccessful ICSI cycles or marked abnormalities in sperm morphology.

Some evidence suggests that combining ICSI with IMSI may improve fertilisation outcomes in selected cases and may increase the proportion of embryos reaching the blastocyst stage, particularly in the context of male-factor infertility or a history of miscarriage.

In essence, IMSI is a tool that can help embryologists select the sperm cell with the most favourable morphology for ICSI.

Ioannis A. Sklavounos MD MSc DFFP
Consultant Obstetrician and Gynaecologist
Specialist Training and Fellowship in the United Kingdom
T.Senior Clinical Fellow – Liverpool Woman’s Hospital UK

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