title: Intracytoplasmic sperm injection outcome versus intracytoplasmic morphologically selected sperm injection outcome: a meta-analysis.
abstract: The development of a modified intracytoplasmic sperm injection (ICSI), called intracytoplasmic morphologically selected sperm injection (IMSI), demonstrated that a profound morphological investigation of the spermatozoon, under the magnification of 6600 x, enables outcome improvement. The aim of this study was to compare ICSI outcome with IMSI outcome. The meta-analysis results demonstrated no significant difference in fertilization rate between ICSI and IMSI groups. However, a significantly improved implantation (odds ratio (OR) 2.72; 95% confidence interval (CI) 1.50-4.95) and pregnancy rate (OR 3.12; 95% CI 1.55-6.26) was observed in IMSI cycles. Moreover, the results showed a significantly decreased miscarriage rate (OR 0.42; 95% CI 0.23-0.78) in IMSI cycles as compared with ICSI cycles. This is the first meta-analysis of published data to evaluate the potential benefits of IMSI. The pooled data of IMSI cycles demonstrate a statistically significant improvement in implantation and pregnancy rates and a statistically significant reduction in miscarriage rates. However, more randomized controlled trials are needed to confirm these results.
authors.affiliation: Sapientiae Institute-Educational and Research Center in Assisted Reproduction, R. Vieira Maciel, 62. 04503-040 São Paulo, SP, Brazil.
authors.forename: Amanda
authors.initials: A
authors.lastname: Souza Setti
authors.forename: Renata Cristina
authors.initials: RC
authors.lastname: Ferreira
authors.forename: Daniela
authors.initials: D
authors.lastname: Paes de Almeida Ferreira Braga
authors.forename: Rita
authors.initials: R
authors.lastname: de Cássia Sávio Figueira
authors.forename: Assumpto
authors.initials: A
authors.lastname: Iaconelli
authors.forename: Edson
authors.initials: E
authors.lastname: Borges
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000648:ultrastructure*; D016896:Treatment Outcome