González-Ortega Claudia, Cancino-Villarreal Patricia, Pérez-Torres Alicia, Vargas-Maciel Marcos Ambrosio, Martínez-Garza Sandra Guadalupe, Pérez-Peña Efrain, Gutiérrez-Gutiédrrez Antonio Martin
Instituto de Ciencias en Reproducción Humana Vida, León, Gto.
Ginecol Obstet Mex. 2010 Dec;78(12):652-9.
Intracytoplasmic sperm injection (ICSI) is highly effective for the control of male factor infertility. The sperm selected for ICSI may have structural abnormalities undetectable to 400x as nuclear vacuoles, decreasing rates of pregnancy and implantation. Recent studies show that with intracytoplasmic morphologically selected sperm injection (IMSI), at higher magnification (> 6,600x), increases pregnancy and implantation rates in patients with repeated failure to ICSI.
To compare the results of the injection of selected motile sperm organelle morphology examination (MSOME) for IMSI, instead of the use of ICSI in patients with repeated failure to ICSI.
Prospective, observational cohort study. Since February 1, 2010 was administered IMSI to couples with at least two failed cycles of ICSI, and analyzed the first 30 cycles in patients under 38 years of good ovarian reserve. This study group was compared with the last 30 cycles of ICSI performed before that date, in patients with similar clinical characteristics. The IMSI was performed with a magnification of 7,676 increases for evaluation and sperm selection.
The groups had similar clinical characteristics. The pregnancy rate with IMSI was better than with ICSI (63 vs. 50%), the difference was not significant for the size of the sample, although the trend is clear and clinically significant in favor to IMSI. The implantation rate with IMSI (44.8%) showed statistically significant differences vs. ICSI (29.7%). No significant differences in abortion rates.
IMSI significantly improves the implantation rate in patients with repeated failure to ICSI.
胞浆内单精子注射（ICSI）在治疗男性因素不孕症方面非常有效。为ICSI选择的精子可能存在在400倍显微镜下无法检测到的结构异常，如核空泡，这会降低妊娠率和着床率。最近的研究表明，通过胞浆内形态学选择精子注射（IMSI），在更高放大倍数（>6600倍）下，可提高ICSI反复失败患者的妊娠率和着床率。
比较在ICSI反复失败的患者中，采用选择的活动精子细胞器形态检查（MSOME）进行IMSI注射的结果，而不是使用ICSI。
前瞻性观察队列研究。自2010年2月1日起，对至少有两个ICSI周期失败的夫妇进行IMSI，并分析38岁以下卵巢储备良好患者的前30个周期。将该研究组与在此日期之前进行的最后30个ICSI周期的具有相似临床特征的患者进行比较。IMSI在7676倍放大倍数下进行，以增加评估和精子选择。
两组具有相似的临床特征。IMSI的妊娠率优于ICSI（63%对50%），尽管样本量差异不显著，但趋势明显且在临床上有利于IMSI。IMSI的着床率（44.8%）与ICSI（29.7%）相比有统计学显著差异。流产率无显著差异。
IMSI显著提高了ICSI反复失败患者的着床率。
