Selection of individual sperm under high magnification microscope, (intracytoplasmic morphologically selected sperm injection or IMSI), involves the uses the apparent most optimal sperm by shape (morphology) in men with the most severe male factor. IMSI has been a consideration in patients with recurrent implantation failure or spontaneous miscarriages (Lo Monte et al. 2013) due to the opinion the pregnancy failures were due to a sperm defect. However, recent studies have opposed this view by showing IMSI does not improve outcomes for men undergoing multiple IVF cycles. (Oliveira et al. 2011, Gatimel et al. 2016).
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