This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid and other abnormalities of the uterus, fallopian tubes and ovaries.
If any defects are found then they can sometimes be corrected with operative Laparoscopy such as the removal of ovarian cysts , removal of PCOD(Polycystic ovarian disease) by LOES, Diathermy to spots of endometriosis, removal of fibroids, opening tubal blocks (by Fallopian tube catheterization or FTC) the list is endless.
Hysteroscopy is a procedure that involves insertion of a narrow telescope-like instrument into the cavity of the uterus (endometrial cavity). The uterine cavity is then distended with fluid and visualized.
The technique for examining sperm to use in IMSI was developed by a team led by Professor Bartoov. In 2002, his team used a high-powered microscope to determine which morphological characteristics of sperm might affect the outcome of ICSI. They suggested that ICSI pregnancy rates may be affected by subtle abnormalities in the shape of the sperm nucleus which embryologists may not detect during normal ICSI sperm selection.
In 2003, the same group published a study that looked at whether selecting sperm using IMSI improves the pregnancy rate in couples with repeated ICSI failures (compared to conventional ICSI).
Comparing results of ICSI with IMSI the pregnancy rate was significantly higher (60% vs 25%) and the miscarriage rate significantly lower (14% vs 40%) in the IMSI group compared to the conventional ICSI group.
There also is a significant improvement in implantation, pregnancy and birth rates using IMSI in patients with two or more previously unsuccessful IVF-ICSI attempts.
The pregnancy rates for patients were 29.8% in the IMSI group compared with 12.9% in the ICSI group. The miscarriage rates for these patients were also significantly lower in the IMSI group compared with the ICSI group
The use of IMSI is limited by the resources needed to carry out the technique. IMSI takes a minimum of 60 minutes and more often takes several hours. In addition the technique involves special equipment to reach the necessary magnification ( X6000), it has to be carried out by experienced embryologists trained in the specific technique, and this explains the significant extra cost of providing IMSI.