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Hum. Reprod. Advance Access published online on October 7, 2004
Human Reproduction, doi:10.1093/humrep/deh545
© 2004 by European Society of Human Reproduction and Embryology
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Received February 5, 2004
Revised June 24, 2004
Accepted September 10, 2004

Article

The morphological normalcy of the sperm nucleus and pregnancy rate of intracytoplasmic injection with morphologically selected sperm

Arie Berkovitz 1, Fina Eltes 2, Shlomit Yaari 3, Nathan Katz 4, Ilya Barr 4, Ami Fishman 1, and Benjamin Bartoov 2*

1 IVF Unit, Department of Obstetrics and Gynaecology, Sapir Medical Centre, Meir Hospital, Kfar Saba, Israel
2 Male Fertility Laboratory, Faculty of Life Sciences, Bar-Ilan University, Ramat Gan, Israel
3 Bar Ilan University, Center for Infrastructures and IS, Ramat Gan, Israel
4 Fertility Medical Centre, Rishon-Le-Zion, Israel

* To whom correspondence should be addressed. E-mail: bartoob{at}mail.biu.ac.il.


  Abstract

BACKGROUND: Our preceding studies have already demonstrated the advantage of intracytoplasmic morphologically selected sperm injection (IMSI) over the conventional IVF-ICSI procedure in terms of pregnancy rate. This study was undertaken to determine whether the increased pregnancy outcome was attributable to the preferred nuclear morphology of the selected spermatozoa, and not to the special sperm preparation technique modified by IMSI. METHODS: Comparison between two matched IMSI groups, i.e. negative comprising 38 cycles, where no spermatozoa with intact nuclei were available for microinjection; and positive, involving ovum microinjection by spermatozoa with strictly defined morphologically normal nuclei. RESULTS: Implantation and pregnancy rates were significantly higher, and abortion rates significantly lower, in the positive group compared with the negative group (25.0±25.9 versus 5.9±12.9%, F=15.8, P≤0.01; 52.6 versus 18.4%, {chi}2=9.7, P≤0.01; and 10.0 versus 57.1%, {chi}2=7.1, P≤0.02, respectively). CONCLUSIONS: Implantation and pregnancy by ICSI is associated with morphological nuclear normalcy of sperm. Sperm with a morphologically abnormal nucleus usually have low fertility potential, but some with certain nuclear abnormalities may still be able to produce pregnancy following ICSI.

Keywords: intracytoplasmic morphologically selected sperm injection (IMSI); male fertility; sperm nucleus.
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