title: The IMSI Procedure Improves Laboratory and Clinical Outcomes Without Compromising the Aneuploidy Rate When Compared to the Classical ICSI Procedure.
abstract: OBJECTIVE
  The intracytoplasmic morphologically selected sperm injection (IMSI) procedure has been associated with better laboratory and clinical outcomes in assisted reproduction technologies. Less information is available regarding the relationship between embryo aneuploidy rate and the IMSI procedure. The aim of this study is to compare the clinical outcomes and chromosomal status of IMSI-derived embryos with those obtained from intracytoplasmic sperm injection (ICSI) in order to establish a clearer view of the benefits of IMSI in infertile patients.
  
  
  METHODS
  We retrospectively analyzed a total of 11 cycles of IMSI and 20 cycles of ICSI with preimplantation genetic diagnosis. The fertilization rate, cleavage rate, embryo quality, blastocyst development, aneuploidy rate, pregnancy rate, implantation rate, and miscarriage rate were compared between the groups.
  
  
  RESULTS
  Similar rates of fertilization (70% and 73%), cleavage (98% and 100%), and aneuploidy (76.9% and 70.9%) were observed in the IMSI and ICSI groups, respectively. The IMSI group had significantly more good quality embryos at day 3 (95% vs 73%), higher blastocyst development rates (33% vs 19%), and greater number of hatching blastocysts (43% vs 28%), cycles with at least one blastocyst at day 5 (55% vs 35%), and blastocysts with good trophoectoderm morphology (21% vs 6%) compared with the ICSI group (P < 0.001). Significantly higher implantation rates were observed in the IMSI group compared with the ICSI group (57% vs 27%; P < 0.05). Pregnancy and miscarriage rates were similar in both groups (80% vs 50% and 0% vs 33%, respectively).
  
  
  CONCLUSIONS
  The IMSI procedure significantly improves the embryo quality/development by increasing the implantation rates without affecting the chromosomal status of embryos. There is a tendency for the IMSI procedure to enhance the pregnancy rates and lower the miscarriage rates when compared with ICSI.
authors.affiliation: FERTILAB Laboratory of Assisted Reproduction, Lima, Perú.
authors.forename: Daniel
authors.initials: D
authors.lastname: Luna
authors.affiliation: PROCREAR Fertility Center, Lima, Perú.
authors.forename: Roly
authors.initials: R
authors.lastname: Hilario
authors.affiliation: PROCREAR Fertility Center, Lima, Perú.
authors.forename: Julio
authors.initials: J
authors.lastname: Dueñas-Chacón
authors.affiliation: PROCREAR Fertility Center, Lima, Perú.
authors.forename: Rocío
authors.initials: R
authors.lastname: Romero
authors.affiliation: PROCREAR Fertility Center, Lima, Perú.
authors.forename: Patricia
authors.initials: P
authors.lastname: Zavala
authors.affiliation: FERTILAB Laboratory of Assisted Reproduction, Lima, Perú.
authors.forename: Lucy
authors.initials: L
authors.lastname: Villegas
authors.affiliation: FERTILAB Laboratory of Assisted Reproduction, Lima, Perú.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Ferreyra
keywords: ICSI; IMSI; MSOME; aneuploidy; implantation; pregnancy