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Intracytoplasmic morphologically selected sperm injection (IMSI) appears to select sperm with lower levels of DNA fragmentation

Date: 6-7-2009

Junca AM, Cohen-Bacrie P, Belloc S, Dumont M, Ménézo Y. Laboratoire d'Eylau-Unilabs, 55, 75116 Paris, France. am.junca@eylau.fr  Gynecol Obstet Fertil. 2009 Jun;37(6):552-7. Epub 2009 May 20

Capsule: Sperm with vacuoles in head vacuoles appear to be related to increased sperm DNA fragmentation.  Selection of sperm at high light microscope magnification (MSOME) for ICSI will likely select sperm with lower levels of DNA fragmentation.

[Article in French, English Abstract] Until now, the morphological sperm analysis (spermocytogram) allows to define sperm normality, but the relationship between sperm morphology and fertility is not yet assessed. Although several studies do not report any relationship between abnormal sperm morphology and ICSI results, nevertheless, the success rate of ICSI seems to be dependent on injected sperm morphological aspect. Detailed morphological sperm examination (especially sperm head) at high magnification (from x 6600 to x 12500) (MSOME) in real time allows to select the best spermatozoa before oocyte injection (IMSI). In some cases, implantation and ongoing pregnancy rates were improved with this sperm selection method. Ultra morphologic criteria were established and the most predictive factor of sperm quality is the presence of vacuoles in the sperm head. Those vacuoles appear to be related to DNA damage (fragmentation and/or denaturation) and affect embryo development. To standardize those observations, several authors tried to establish sperm MSOME classifications in order to be used in routine and to replace the conventional spermocytogram in the next future.