Published online by Cambridge University Press: 02 December 2021
Application of intracytoplasmic morphologically selected sperm injection (IMSI) is a matter of debate; however, it is evident that deselection of spermatozoa presenting respectively spermatozoa with vacuole-like structures and asymmetrical insertion of the neck has multiple benefits. Defective sperm function and molecular defects contribute to early embryonic development disturbance, failure of blastocyst formation, miscarriages, and congenital birth defects. Introduction of IMSI has made embryologists aware that for ICSI the selection of sperm should be given proper attention. We have to consider IMSI has improved the ICSI technique. Compared to “blind” spermatozoa aspiration at low magnification and/or reduced optics contrast, observation under optimal contrast optics increases the probability of selecting a normal spermatozoa. This is particularly evident in cases of severe teratozoospermia, with low responder and advanced age women. Practicable and technical aspects of morphologically normal sperm selection must be considered to facilitate the workflow while performing IMSI and avoiding damage to the oocytes. A proper set up of the dish for selecting and capturing sperm facilitates routine application of IMSI.