title: Intracytoplasmic injection of morphologically selected spermatozoa (IMSI) improves outcome after assisted reproduction by deselecting physiologically poor quality spermatozoa.
abstract: OBJECTIVE
  We used computer assisted sperm selection (MSOME) during cycles of intracytoplasmic sperm injection to test whether this technique improves results over traditional ICSI protocols. We also used the TUNEL assay to test whether MSOME could deselect physiologically abnormal spermatozoa.
  
  
  METHODS
  Individual spermatozoa were examined with MSOME. Normal and abnormal spermatozoa were tested for the level of DNA fragmentation using TUNEL assay. In a prospective, randomized trial, patients were selected for standard ICSI, or IMSI techniques. We tested the two groups for biological and clinical parameters.
  
  
  RESULTS
  64.8% of spermatozoa, otherwise selectable for ICSI, were characterized by abnormalities after computer-assisted sperm analysis. These sperm were also characterized by an increase in the level of DNA fragmentation. We noted an increase in embryo quality, pregnancy and implantation rates after computerized sperm selection during ICSI procedures.
  
  
  CONCLUSIONS
  Computerised selection of spermatozoa during ICSI procedures deselects physiological abnormal spermatozoa and improves clinical results.
authors.affiliation: Centro Fecondazione Assistita, Clinica Villa del Sole, Via Manzoni 15, 80122, Napoli, Italy. martinwilding@hotmail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Wilding
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Coppola
authors.forename: Loredana
authors.initials: L
authors.lastname: di Matteo
authors.forename: Antonio
authors.initials: A
authors.lastname: Palagiano
authors.forename: Enrico
authors.initials: E
authors.lastname: Fusco
authors.forename: Brian
authors.initials: B
authors.lastname: Dale
mesh_terms: D000328:Adult; D053938:DNA Fragmentation; D005260:Female; D006801:Humans; D007246:Infertility; D007248:Infertility, Male / Q000628:therapy; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012661:Semen / Q000502:physiology; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000648:ultrastructure*; D016896:Treatment Outcome