User:Sheypaul06/Intracytoplasmic morphologically selected sperm injection

INTRACYTOPLASMIC MORPHOLOGICALLY SELECTED SPERM INJECTION(IMSI) Sperm morphology evaluation plays a crucial role in the diagnosis of male fertility potential and it has demonstrated a predictive value for fertilization and pregnancy outcomes in IVF treatments (Kruger et al., 1986, 1987; Parinaud et al., 1993; Ombelet et al., 1997; Eilish et al., 1998). A different prognosis can be assigned on the basis of different normal morphology thresholds (poor prognosis: ≤4%; good prognosis: 5–14%; normal: >14%) in order to choose an adequate infertility management (Kruger et al., 1988; Grow et al., 1994). Following the introduction of micro-insemination techniques in humans (Ng et al., 1988; Fishel et al., 1990; Palermo et al., 1992; Antinori et al., 1995) sperm morphology evaluation has lost its exclusive diagnostic role to become an active part of the laboratory procedure once the embryologist has begun to select a motile, normal-looking spermatozoon to be injected into the oocyte under ×200/400 magnification. Sperm selection is based on the judgment of an embryologist who selects the most normal-looking spermatozoon available under ×200/400 magnification (Figure 1). Several authors have shown how the correct selection of spermatozoa improves intracytoplasmic sperm injection (ICSI) outcome (Kahraman et al., 1999; Miller and Smith, 2001; De Vos et al., 2003). Because of the subjective nature of this evaluation, several instruments for computerized sperm morphology analysis have been developed (Davis et al., 1992; Kruger et al., 1995; Lau and Chalmers, 1995; Sukcharoen et al., 1998), and recently new devices to achieve high magnification levels have been