Pregnancy rates are higher with intracytoplasmic morphologically selected sperm injection than with conventional intracytoplasmic injection.
OBJECTIVE
To verify whether microinjection into retrieved oocytes of motile spermatozoa with morphologically normal nuclei, strictly defined by high power light microscopy (x >6000), improves the IVF/intracytoplasmic sperm injection (ICSI) pregnancy rate in couples with repeated ICSI failures.


METHODS
Comparative prospective study testing routine IVF/ICSI outcome parameters against those of modified ICSI based on morphological selection of spermatozoa with normal nuclei.


METHODS
Male factor fertility laboratory and IVF center.


METHODS
Sixty-two couples, with at least two previous consequent pregnancy failed ICSI cycles, underwent a single ICSI trial preceded by morphological selection of spermatozoa with normal nuclei. Fifty of these couples were matched with couples who underwent a routine ICSI procedure at the same IVF center and exhibited the same number of previous ICSI failures.


METHODS
Standard ICSI and modified ICSI.


METHODS
ICSI pregnancy rate.


RESULTS
The matching study revealed that pregnancy rate after modified ICSI was significantly higher than that of the routine ICSI procedure (66.0% vs. 30.0%).


CONCLUSIONS
Microinjection into retrieved oocytes of selected spermatozoa with strictly defined morphologically normal nuclei improves significantly the incidence of pregnancy in couples with previous ICSI failures.
Bartoov
Benjamin
B
Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel. bartoob@mail.biu.ac.il
Berkovitz
Arie
A
Eltes
Fina
F
Kogosovsky
Avraham
A
Yagoda
Arie
A
Lederman
Hanna
H
Artzi
Shira
S
Gross
Moshe
M
Barak
Yona
Y
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007248:Infertility, Male / Q000628:therapy; D008297:Male; D008845:Microinjections; D009865:Oocytes / Q000166:cytology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D013076:Sperm Count; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000166:cytology* / Q000473:pathology; D017211:Treatment Failure