SPERMATOZOA IV : MSOME, IMSI, SICSI

The several morphologic criteria currently used in routine
sperm analysis to describe the general picture of the spermatozoa originating from the raw ejaculate are based on the examination of fixed and stained sperm cells. It is accepted that the morphologic characteristics may not necessarily describe the quality of the specific single spermatozoon in the processed sperm fraction that was injected into the oocyte.
De Vos et al., who studied individual injected sperm and the formation and development of the resultant embryo, admitted that the low magnification (i.e., routine magnification of X400 during ICSI) and concomitant low resolution of the sperm morphology assessment on motile spermatozoa before ICSI were limitations of their study.

To date, The high-power magnification was provided by an inverted light microscope with a magnification of x1500 with a zoom of up to x6100 and higher (MSOME).

ICSI (x 400)	IMSI (x 6100)

IMSI
The Selection of sperm cells for IVF-ICSI by intracytoplasmic morphologically selected sperm injection (IMSI) is now possible (Bartoov B., Berkovitz A. and All. - 2002).
To day, several Teams works about à system of classification for using the best spermatozoa after observation with MSOME system.
They also try understanding what the abnomalies are et why they are important. But results are already there.

INDICATIONS
According to B. Bartoov:
This treatment can be recommended in the following cases :
- For couples with unexplained infertility (UI) who failed in previous IVF and MSOME indicates low rate of spermatozoa with a normal nucleus (Nucleoteratozoospermia).
- For men whose semen quality is very poor.
- For men in whom isolated sperm cells were taken from the testicular tissue (TESE/TFNA).
- For cases of recurring abortion in the first trimester in which a high percent of vacuoles were found in the sperm cell head using the MSOME.
- For couples for whom it was recommended to use a donor egg but with a poor semen quality according to the MSOME.
(source : B. Bartoov : website)

SICSI
Scored intracytoplasmic sperm injection.
Cassuto NG and All - 2008. have established a new classification scoring scale for individual spermatozoon with the highest predictive fertilizing potential in real time of the injection during ICSI