IMSI
Dr Irfana Koita - Fertility specialist
Created on: 12-29-2015
Updated on: 11-07-2023
Edited by: Kate Forristal
What is IMSI?
Intracytoplasmic morphologically selected sperm injection (IMSI), also called “Super ICSI”, is an in vitro fertilization technique that aims to select the best sperm to increase the chances of successful implantation. It requires local anesthesia with sedation in the ovarian puncture procedure. You should see a fertility specialist for this treatment.
Why is IMSI performed?
IMSI is indicated in the following specific cases:
- numerous failed transfer attempts
- patients with severe teratozoospermia (high number of spermatozoa with abnormal or strange shapes in the semen)
- patients with high sperm DNA fragmentation
- long-term sterility of unknown origin
What happens during IMSI?
This technique consists of previously selecting the sperm through a microscope of approximately 6,000 times, 15 times more powerful than the microscope used in ICSI. Thanks to this microscope, sperm with abnormalities are discarded based on the morphology they present.
Sperm without abnormalities are implanted one by one in each embryo via intracytoplasmic injection. Finally, between one and three embryos are selected for transfer, which consists in introducing a thin catheter into the end of the uterus.
Preparing for IMSI
As in any other in vitro fertilisation technique, it is important to consider three points before treatment:
- Nutrition: it is important to take folic acid and vitamin D, since they increase the chances of pregnancy. Therefore, it is recommended to eat fresh fruit and vegetables, legumes, whole grains, dairy products and meat, and avoid fast food, foods with a high content of trans fats and sugars and low in vitamins and minerals.
- Exercise: it’s important to keep exercising, but not to overexert yourself during this period
- Sleep: make sure you get eight hours of sleep a day and that you go to bed and get up at regular times
Aftercare
Aftercare following an embryo transfer is a crucial part of the in vitro fertilisation (IVF) process to optimise the chances of a successful pregnancy. Here's more information on the key aspects of aftercare:
Avoid strenuous physical activity: After the embryo transfer, it is generally recommended that the woman avoids strenuous physical activities, such as heavy lifting, intense exercise, or any activity that may put excess strain on the body. Rest and relaxation are encouraged during this period to minimise the risk of disrupting the implantation process.
Progesterone administration: Progesterone is a hormone that plays a vital role in maintaining pregnancy. Following an embryo transfer, it is common for women to be prescribed progesterone supplementation. This can be administered orally or via injections for a duration of 8 to 10 weeks after the transfer. Progesterone helps prepare the uterine lining for implantation and supports the early stages of pregnancy until the placenta can take over hormone production.
Pregnancy test: Typically, a pregnancy test is scheduled for 12 to 14 days after the embryo transfer. This timing allows for the detection of a pregnancy hormone called human chorionic gonadotropin (hCG) in the woman's bloodstream. A positive pregnancy test at this stage indicates that the embryo has successfully implanted in the uterine lining.
Monitoring for symptoms: It is essential for the woman to monitor her health during the post-transfer period. Some symptoms, such as pelvic pain, fever above 38ºC (100.4ºF), blood in the urine, or vaginal bleeding, can be concerning and may require immediate medical attention. These symptoms can sometimes indicate complications like infection or a potential issue with the pregnancy, and prompt evaluation by a specialist is crucial.
Continued care: After a positive pregnancy test, the woman will continue to receive care and monitoring from her fertility specialist or obstetrician. This includes regular check-ups, ultrasounds to monitor the pregnancy's progress, and adjustments to medications or treatments as necessary.