title: Clinical outcome after IMSI procedure in an unselected infertile population: a pilot study.
abstract: BACKGROUND
  To date the IMSI procedure represents the only real-time and unstained method available to discard spermatozoa with ultrastructural defects. Several studies demonstrated that IMSI provides positive results in couples with severe male factor infertility or repeated ICSI failures. Aim of this pilot study is to evaluate the differences between IMSI and ICSI in terms of IVF outcomes in an unselected infertile patient population.
  
  
  METHODS
  Three hundred and thirty-two couples were analyzed: 281 couples underwent conventional ICSI procedure and 51 underwent IMSI technique.
  
  
  RESULTS
  No statistically significant differences were found between implantation rate (ICSI: 16,83%; IMSI: 16,67%), fertilization rate (ICSI: 77,27%; IMSI: 80,00%) and pregnancy rate (ICSI: 25,30%; IMSI: 23,50%). Both groups were comparable when considering live birth rate (ICSI: 11,39%; IMSI:13,72%), ongoing pregnancy rate (ICSI: 7,47%; IMSI: 5,88%) and miscarriage rate (ICSI: 17,78; IMSI: 5,26%). The subgroup analyses did not show a statistical difference between ICSI and IMSI neither in male factor infertility subgroup nor in patients with more than one previous ICSI attempt. A trend towards better laboratory and clinical outcomes was detected in the male factor infertility subgroup when IMSI was applied.
  
  
  CONCLUSIONS
  Our preliminary results show that the IMSI technique does not significantly improve IVF outcomes in an unselected infertile population.
authors.affiliation: Section of Gynecology and Obstetrics Infertility Unit, Department of Growth and Reproduction, Sant'Anna University Hospital, Via Aldo Moro 8, 44100 Cona-Ferrara, Italy. roberto.marci@unife.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Marci
authors.forename: Fabien
authors.initials: F
authors.lastname: Murisier
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Monte
authors.forename: Ilaria
authors.initials: I
authors.lastname: Soave
authors.forename: Alain
authors.initials: A
authors.lastname: Chanson
authors.forename: Françoise
authors.initials: F
authors.lastname: Urner
authors.forename: Marc
authors.initials: M
authors.lastname: Germond
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007246:Infertility / Q000628:therapy*; D008297:Male; D010865:Pilot Projects; D011247:Pregnancy; D011256:Pregnancy Outcome; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*