Dr. Anil Pichad

Of a million sperms released in one ejaculation, a single sperm manages to fertilize the egg, which grows into an embryo and then a baby. Due to various reasons, when this does not happen, it is termed as infertility and is currently on the rise.

With IVF, couples sometimes go through multiple sessions to ensure fertilization. ICSI or intracytoplasmic sperm injection improved this chance of fertilization. It is where a single sperm is used to fertilize an egg in an artificially controlled environment and then injected into the uterus where it grows further.

The next step in this technique is IMSI, where the chances of successful pregnancy are further enhanced and also promises improved quality of the embryo. IMSI, as it stands for, has “morphologically selected” which means under a highly powerful microscope, the best sperms are selected and then used to fertilize the egg. Morphology stands for shape, and the shape of the sperm is a direct indicator of the sperm quality. This not just ensures good success rate but also ensures the sperm which is used produces a high-quality embryo.

Features

1. High success rate of fertility
2. Reliable and efficient method of ART (assisted reproductive technology)
3. More expensive than traditional IVF methods or ICSI
4. Requires complex equipment, training, and set-up

Indications:

1. Useful in couples who have failed IVF previously
2. Male infertility with unidentifiable cause
3. Poor sperm quality

What to expect?

Both partners are prepared both physically and mentally prior to IMSI.

Before the procedure - men:

1. A screening is first done to decide if the sperms can be used directly
2. In case of hereditary diseases, a donor is preferred
3. The first technical step involves sperm collection, either directly or through a donor
4. Sperms are collected either through masturbation or through a small incision in the testicles
5. Sperms used could be fresh or frozen; fresh ones may be stored for later use also

Before the procedure – women:

1. The woman is put on some ovulation therapy to ensure the release of multiple eggs, so a good one is picked. These high doses of hormones ensure multiple eggs are released.
2. Egg release is monitored through blood and urine tests
3. They are collected within after 36 hours of release

During the IMSI procedure:

1. A healthy egg is chosen and placed in a glass container containing hyaluronidase
2. Sperms are placed in a medium which will slow their movement, which enables picking a good sperm for fertilization
3. The dual advantage of this is that in addition to a high success rate of fertilization, the quality of the embryo is also assured

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