Intra-cytoplasmic Morphologically selected Sperm Injection (IMSI)

IMSI is a technique where the examination and the selection of sperm are done using a high-magnification digital imaging microscope prior to micro-injection of the egg. Here sperm head abnormalities or neck abnormalities can be identified clearly. A progressive high quality sperm is selected to be injected.

Patients who will benefit from IMSI

Patients with high number of abnormal sperms

Patients with recurrent miscarriages

IMSI procedure steps
  1. Ovulation induction and follicle tracking
    • Induction is done by stimulating the ovaries
    • This stimulation is done by administrating hormonal medication such as FSH (Follicle Stimulating Hormone)
    • The female partner’s hormone levels are checked using blood tests
    • Simultaneously ultra sound scans are performed to monitor follicular development
  2. Oocyte maturation
    • HCG injection is administered for the final maturation of the eggs developing in the follicle
  3. Oocyte recovery
    • Transvaginal ultrasound aspiration is done to retrieve the eggs
    • Egg recovery procedure performed under anesthesia
    • The aspirated follicle fluid is examined and the mature eggs are separated and placed in culture media and incubated
  4. Sperm preparation
    • Preparation will separate the immotile and morphologically abnormal sperms
    • The final wash will have motile sperms with normal morphology
  5. Fertilisation and embryo development
    • The prepared sperms are observed under a high power microscope lens with higher magnification

    • The sperms with good morphology are selected to be injected to the incubated eggs

      tracking

    • The injected egg is incubated and the next day is check for fertilisation
    • The fertilised egg develops to an embryo in laboratory conditions
    • Embryo development is monitored and then optimally developed cleavage stage (day 3) embryos or blastocyst (day 5 embryos) are selected to be transferred and rest is frozen
    • Additionally more advanced techniques to assist further embryo development could be used such as, zona thinning and assisted hatching
  6. Embryo transfer and Serum βhCG test
    • Progesterone supplement is given to make the uterine lining ideal for implantation

    • The selected embryos are transferred to the uterine cavity

    • After 14 days pregnancy is identified by a βhCG test and further confirmed through an ultra sound scan