What is Intracytoplasmic Morphological Sperm Injection (IMSI)?
Intracytoplasmic Morphological Sperm Injection (IMSI) is an advanced assisted reproductive technology (ART) used in fertility treatment, specifically in vitro fertilization (IVF). It enhances the traditional intracytoplasmic sperm injection (ICSI) method by selecting and injecting sperm cells with higher magnification and morphological assessment. This improves the chances of successful fertilization and embryo development.
IMSI is a specialized form of ICSI. It involves using a highly magnified microscope to carefully assess the morphology (shape and structure) of sperm cells before selecting and injecting sperm into an egg during IVF. This technique aims to identify and choose sperm cells with the best morphology, as it's believed that sperm with normal morphology may have a higher potential for successful fertilization and healthy embryo development.
Types of IMSI
IMSI is generally a single, highly specialized procedure, but can be integrated with other ART methods:
- Conventional IMSI: High-magnification sperm selection and injection into eggs.
- IMSI with ICSI: Combines IMSI sperm selection with standard ICSI embryo transfer.
- IMSI with PGT: Selected sperm are used with Preimplantation Genetic Testing for better embryo quality and genetic screening.
2-3 Weeks Per Cycle
Surgery Duration
Sedation During Egg Retrieval
Anesthesia Used
Same Day Discharge
Hospital Stay
1-2 Days Post Egg Retrival
Full Recovery Timeline
What are the Indications for the Procedure
- Abnormal Sperm Morphology: When a significant portion of a man's sperm exhibits abnormal morphology, IMSI can select sperm with more normal morphology for injection.
- Previous IVF/ICSI Failures: Couples or individuals who have experienced repeated IVF or ICSI failures might consider IMSI to enhance their chances of successful fertilization.
- Unexplained Infertility: IMSI can be explored in cases of unexplained infertility to optimize sperm selection and improve fertilization outcomes.
- Severe Male Factor Infertility: IMSI might be recommended for severe sperm abnormalities to increase the likelihood of successful fertilization.
- Advanced Maternal Age: IMSI can help ensure that the best-quality sperm are used for fertilization when egg quality is a concern.
- Recurrent Pregnancy Loss: IMSI may address potential sperm-related factors contributing to unsuccessful embryo development in couples with recurrent pregnancy loss.
Who Needs IMSI?
IMSI is recommended for couples who have experienced repeated IVF/ICSI failures or have severe male infertility issues.
You may need IMSI if you experience:
- Recurrent failed fertilization in IVF/ICSI cycles
- Low sperm motility or abnormal sperm shape
- History of repeated miscarriages linked to male factor
- Difficulty conceiving despite regular intercourse and normal female fertility tests
- Desire to maximize embryo quality and implantation chances
How to Prepare for IMSI
Preparation for IMSI is similar to standard IVF/ICSI cycles:
- Initial Evaluation: Complete fertility assessment for both partners.
- Ovarian Stimulation: Medications are given to produce multiple eggs for retrieval.
- Semen Preparation: Sample is collected and processed; sometimes surgically retrieved sperm may be required.
- Lifestyle Modifications: Avoid smoking, alcohol, stress, and maintain a nutrient-rich diet.
- Counseling: Emotional preparation and understanding of procedure, recovery, and costs.
What Happens During IMSI Treatment
Before IMSI
- Initial Consultation: Couples or individuals visit a fertility specialist to discuss their medical history, concerns, and potential treatment options, including IMSI.
- Sperm Collection: A semen sample is collected from the male partner or a sperm donor if needed.
- Sperm Analysis: The collected sperm sample undergoes a thorough analysis to assess parameters like sperm count, motility, and morphology.
During IMSI
- Sperm Selection and Preparation: Specialized microscopes with high magnification capabilities are used to identify sperm with the best morphology.
- Microscopic Examination: Sperm are evaluated for their shape, size, and structural integrity. Embryologists aim to identify sperm with the least morphological abnormalities.
- Sperm Injection: A single healthy sperm is immobilized and carefully injected into the cytoplasm of a fully developed egg using specialized micromanipulation tools.
After IMSI
- Embryo Culture: Fertilized eggs (now embryos) are cultured in a controlled laboratory environment for a few days.
- Embryo Transfer: Viable and healthy embryos are transferred into the uterus of the female partner or gestational carrier.
- Pregnancy Test and Follow-up: Two weeks after the embryo transfer, a pregnancy test is performed. If the test results are positive, further monitoring and prenatal care follow.
- Pregnancy Outcome: Successful implantation and a viable pregnancy lead to ongoing prenatal care and support throughout the pregnancy.
Recovery After IMSI Procedure
The recovery process after IMSI is generally straightforward and mild.
- Immediate Post-Procedure Period: After IMSI, you will spend a short period in the recovery area to ensure you're feeling well before leaving.
- Rest and Normal Activities: It is recommended that you rest for the remainder of the day, but you can resume normal activities the next day. Avoid strenuous physical activities or heavy lifting for a few days.
- Discomfort or Mild Cramping: Some individuals might experience mild discomfort, bloating, or mild cramping, usually subsiding within a day or two.
- Medications: Hormonal medications or supplements might be prescribed to support the uterine lining and implantation. Follow the medication instructions provided by your medical team.
- Hydration and Diet: A balanced diet and adequate water intake support overall well-being during recovery.
- Emotional Well-being: The post-IMSI period can be emotionally charged. It's important to have a support system and engage in relaxing activities.
- Follow-Up Appointments: Your fertility clinic will schedule follow-up appointments for monitoring and guidance through the next steps of the pregnancy journey.
- Pregnancy Testing: If IMSI is part of an IVF cycle, a pregnancy test will be taken two weeks after embryo transfer.
- Potential Pregnancy Symptoms: Some individuals might experience mild pregnancy symptoms like breast tenderness, fatigue, or changes in appetite due to hormonal medications.
- Emotional Support: Regardless of the pregnancy test result, it can be beneficial to have emotional support from loved ones or seek professional counseling.
By following these guidelines, you can optimize your experience and recovery during the IMSI procedure.
Follow-Up After IMSI
- First Follow-Up: 2 weeks post-transfer to check pregnancy result.
- Ultrasound Scan: After 4-5 weeks to confirm gestational sac and fetal heartbeat.
- If Cycle Fails: Doctor analyzes causes and plans future ART strategies.
- Long-Term: Regular monitoring throughout pregnancy if successful.
Benefits of IMSI
- Improves fertilization rates in cases of poor sperm quality
- Selects sperm with the best morphology, reducing DNA damage risk
- Increases chances of healthy embryo development and implantation
- Reduces risk of miscarriage in repeated ART failures
- Useful for older men or men with severe sperm abnormalities
- Can be combined with genetic screening for safer pregnancy outcomes
Risks of IMSI
IMSI is generally safe, but minor risks include:
- Egg or embryo damage during injection (rare)
- Emotional stress if fertilization or implantation fails
- Multiple pregnancy risk if multiple embryos are transferred
- Hormonal side effects due to ovarian stimulation
- Slightly higher procedure cost compared to standard ICSI
How Much Does IMSI Cost in India?
- Standard IMSI: Rs. 2,00,000 - Rs. 3,50,000 per cycle
- IMSI with Genetic Testing or Donor Sperm: Rs. 3,50,000 - Rs. 5,00,000+
Costs vary depending on sperm source, number of eggs, use of advanced microscopes, and clinic location.
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