What are the most frequent causes of male infertility?
Sometimes there is no evident cause. However, factors such as varicocele, testicular infections, genetic diseases, and the use of drugs, alcohol and smoking impact on the quantity, motility and/or morphology of spermatozoids.
What are the main procedures used in the case of male infertility?
In mild and moderate cases, intrauterine inseminations can be used. In cases of severe male infertility, in vitro fertilization (IVF) with or without intracytoplasmic sperm injection (ICSI) has to be used.
What are the main points to look at in a semen analysis?
The main points are sperm concentration, motility and morphology.
What is the meaning of teratozoospermia?
Teratozoospermia is the term used for referring to an alteration in the morphology of the sperm. It is mild when morphology is less than 14% normal (using strict criteria or Kruger criteria). It is severe when it is less than 4% normal.
Are there any other studies that can be done if I have severe teratozoopermia?
Patients with teratozoospermia should be studied in depth. Several studies, including electronic microscopy, can help in understanding what the pathology present in the semen is, what the prognosis is, and can help the biologists who do the ICSI to choose a healthy sperm to be injected into the oocyte.
What is MSOME?
MSOME is a real-time, high magnification motile sperm organellar morphology examination. It is a diagnosis tool that allows embryologists to magnify sperm up to 6,000 times and let us decide if conventional ICSI is good enough or if IMSI may offer a benefit. This is the same technology that is used in IMSI.
What is IMSI?
Intracytoplasmic morphologically selected sperm injection (IMSI) is a technology that allows embryologists to magnify sperm up to 6,000 times compared to the standard 200 to 400 times magnification associated with traditional fertilization approaches. This is the same technology that is used in MSOME but this is a therapeutic tool.
What do embryologists see when they do IMSI?
IMSI makes it possible to discard sperm whose nuclei have an abnormal shape or contents. The optimum nucleus is smooth and symmetric, with an oval configuration. Using IMSI, the embryology team can identify any malformation or vacuole in the nuclear mass and they can choose the spermatozoa with optimal length and width.
Who may obtain benefit from using IMSI?
Men whose semen sample shows less or equal to 4-6% of normal spermatozoa (by the strict Kruger morphology criteria) may benefit from IMSI.
What are the risks when using IMSI?
IMSI is still an investigational technology that is supposed to be at least as good as conventional ICSI, but has the potential of having better results in those cases that may benefit from it. Some papers have already published increased pregnancy rates. Nowadays, all over the world, hundreds of children have already born after doing IMSI with no increased abnormalities. There are no theoretical risks in using IMSI.
What should I do if I have severe teratozoospermia (a strict Kruger morphology index below 6%)?
A patient with a severe alteration in the sperm morphology should retrieve a semen sample for MSOME. Depending on morphologic alterations found, IMSI may be suggested. If morphologic alterations are not too important, conventional ICSI will be suggested.
Can I use my own sperm if I have azoospermia?
If you have azoospermia, you should undergo a testicle biopsy. Sometimes sperm is present in testicle but not in semen. If it is not present, donor semen should be used. There are some other tests like karyotype and chromosome Y microdeletions in the blood which can help in understanding the prognosis and the possible inheritance pattern of this pathology.
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