title: The prevalence of sperm with large nuclear vacuoles is a prognostic tool in the prediction of ICSI success.
abstract: OBJECTIVE
  To investigate if there is a correlation between the prevalence of sperm with large nuclear vacuoles (LNV) and intracytoplasmic sperm injection (ICSI) outcomes.
  
  
  METHODS
  Two hundred male patients undergoing ICSI had their sperm morphology evaluated through motile sperm organelle morphology examination (MSOME) and the percentage of LNV sperm was recorded and correlated to the ICSI outcomes.
  
  
  RESULTS
  The percentage of sperm with LNV negatively influenced the blastocyst formation (S: 16.9, R(2): 20.5%, p = 0.004) and implantation (S: 34.7, R(2): 26.2%, p = 0.001). There were significant differences in the percentage of sperm with LNV between patients in which pregnancy was achieved or not (22.2% vs. 28.4%, p < 0.001) and in patients with ongoing pregnancy or not (22.4% vs. 28.5%, p < 0.001). The incidence of sperm with LNV was determinant to the decreased odds of pregnancy (OR: 0.74, p < 0.001) and increased odds of miscarriage (OR: 1.46, p < 0.001). The area under the curve (AUC) was sufficient to distinguish between couples which did achieve pregnancy or not (AUC: 0.922, p < 0.001).
  
  
  CONCLUSIONS
  The MSOME is a prognostic tool in the prediction of ICSI success and could be used to select patients that should have their sperm selected by MSOME for ICSI.
authors.affiliation: Instituto Sapientiae-Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, Brazil, Zip: 04503-040.
authors.forename: Amanda Souza
authors.initials: AS
authors.lastname: Setti
authors.forename: Daniela Paes
authors.initials: DP
authors.lastname: de Almeida Ferreira Braga
authors.forename: Livia
authors.initials: L
authors.lastname: Vingris
authors.forename: Rita
authors.initials: R
authors.lastname: de Cassia Savio Figueira
authors.forename: Assumpto
authors.initials: A
authors.lastname: Iaconelli
authors.forename: Edson
authors.initials: E
authors.lastname: Borges
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D047108:Embryonic Development; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D055101:Semen Analysis; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D013094:Spermatozoa / Q000254:growth & development / Q000648:ultrastructure*; D014617:Vacuoles / Q000648:ultrastructure*