title: Intracytoplasmic morphologically selected sperm injection (IMSI) does not improve outcome in patients with two successive IVF-ICSI failures.
abstract: OBJECTIVE
  Assessment of sperm morphology has been reconsidered since 2001 with the development of motile sperm organelle morphology examination (MSOME). This observation technique that combines high magnification microscopy and the Nomarski interference contrast makes it possible to select spermatozoa with as few vacuoles as possible before microinjection into the oocyte (intracytoplasmic morphologically selected sperm injection, IMSI). More than 10 years after the development of IMSI, the indications of the IMSI technique and its ability to increase pregnancy and/or birthrates (compared with conventional ICSI) are still subject to debate. We aimed to better define the interest of IMSI in the third attempt.
  
  
  METHODS
  We assessed the benefit of IMSI by carrying out a retrospective comparative study between IMSI and conventional ICSI during a third ART attempt. Two hundred sixteen couples with two previous ICSI failures were studied between February 2010 and June 2014.
  
  
  RESULTS
  IMSI did not significantly improve the clinical outcomes compared with ICSI, either for implantation (12 vs 10%), clinical pregnancy (23 vs 21%), or live birth rates (20 vs 19%).
  
  
  CONCLUSIONS
  This study provides supplementary arguments for not achieving IMSI procedure in the third attempt after two previous ICSI failures.
authors.affiliation: Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 Avenue de Grande Bretagne, 31059, Toulouse, France. nicolasgatimel@yahoo.fr.|Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), 330 Avenue de Grande Bretagne, 31059, Toulouse, France. nicolasgatimel@yahoo.fr.
authors.forename: N
authors.initials: N
authors.lastname: Gatimel
authors.affiliation: Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 Avenue de Grande Bretagne, 31059, Toulouse, France.|Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), 330 Avenue de Grande Bretagne, 31059, Toulouse, France.
authors.forename: J
authors.initials: J
authors.lastname: Parinaud
authors.affiliation: Service de Médecine de la Reproduction, Hôpital Paule de Viguier, CHU Toulouse, 330 Avenue de Grande Bretagne, 31059, Toulouse, France.|Université Paul Sabatier Toulouse-III, Groupe de Recherche en Fertilité Humaine (EA 3694, Human Fertility Research Group), 330 Avenue de Grande Bretagne, 31059, Toulouse, France.
authors.forename: R D
authors.initials: RD
authors.lastname: Leandri
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000628:therapy; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D055101:Semen Analysis / Q000379:methods*; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*; D017211:Treatment Failure
keywords: ICSI failure; IMSI; MSOME; Sperm selection; Vacuoles