The internationally accepted IMSI technique ensures higher rate of successful pregnancies, reduced abortion rates among IVF-induced pregnancies. Dr Rajan S Vaidya is a practising gynaecologist, obstetrician  and  IVF Consultant  since  1991, his Kalyan-based clinic is the first individually owned IVF Centre in Maharashtra to deploy the IMSI equipment. M&B quizzes him on the technique and its benefits...

WHAT IS IMSI AND HOW IS IT ASSOCIATED WITH ASSISTED REPRODUCTION?
IMSI is an abbreviation of ‘Intra-cytoplasmic Morphologically assisted Sperm Injection.’

Assisted Reproduction embodies a lot of techniques to enhance the chances of conception for a woman. In the prevalent technique called ICSI (Intra-cytoplasmic Sperm Injection), an infertile woman is given injections called Gonadotrophins, which enable more oocytes (eggs) to grow and mature. At an opportune growth stage, these eggs are aspirated (collected) from her ovary by special needles, under a minor anaesthesia, and each of these mature eggs is injected with her partner’s sperm under a highly powerful microscope. In the ICSI technique, the sperm to be injected is magnified only 200 times its size. However, in the IMSI technique, the sperm is magnified 7200 times its size! This enables the sperm’s sub-cellular structural defects – like vacuoles etc – to be seen easily. These would not be evident at all under the 200 times magnification of ICSI. Thus, IMSI enables us to select the morphologically healthiest sperm thereby enabling higher pregnancy rates. IMSI is, thus, the most advanced technique of selecting the best sperm, far ahead of ICSI.

IN WHAT WAYS IS IT BETTER THAN OTHER METHODS OF ASSISTED REPRODUCTION?
As detailed above, IMSI selects the best sperm. This results in higher pregnancy rates than the prevalent ICSI technique. Also, since the best sperm is selected, the abortion rate of these pregnancies achieved through IMSI, is 40 per cent lower than those achieved through pregnancies  through ICSI.

WOULD YOU SAY THEN, THAT IT IS POSSIBLE TO GET THE FITTEST SPERM AND THUS, THE FITTEST EMBRYO POSSIBLE?
Yes, one gets the fittest sperm by the currently available IMSI technique. This ultimately translates into the fittest embryo.

WHAT KIND OF PEOPLE CAN BENEFIT FROM THIS TECHNOLOGY? HOW?
The technique is mainly useful in the following cases:
*‘Male factor’ as a cause of infertility, i.e.,
a) men who have a very low sperm count,
b) men whose sperms show poor motility
c) men with a higher percentage of abnormal sperms in their semen d) elderly males (since they are more likely to have abnormal or weak sperms)
* If the couple has had more than two ICSI attempt failures (ie, those couples who have failed test tube baby attempts on two occasions).
* It can be particularly beneficial if the prevalent ICSI technique succeeds but the woman recurrently aborts in the first trimester, leaving the couple childless.

CAN GENETIC MATERIAL TRANSFER BE CONTROLLED IN THIS TECHNIQUE?
No. However, it is deduced that a morphologically normal sperm under the highest magnification of IMSI (7200 times) is less likely to carry defective genetic material than the the 200 times magnified sperm under ICSI.

HOW OLD IS THIS TECHNOLOGY? HOW MANY HOSPITALS IN INDIA HAVE IT?
This is the latest technology, about three to four years old, and only a couple of corporate hospitals in the country possess it. Ours, for example, is the first ‘ individually owned’ IMSI equipment, the first in Thane District and only the 4th in the whole of Maharashtra!

WHAT ARE COSTS INVOLVED?
The costs, ultimately, depend on various factors involved in the particular couple’s infertility problem. Roughly, each attempt would average at about Rs 1,50,000.

AS A DOCTOR, WHAT WOULD YOU SAY, ARE THE DISADVANTAGES OF THIS TECHNOLOGY?
Technologically, IMSI, till date, is the best or ultimate in the field of Assisted Reproduction, its only disadvantage, rather limitation, being it’s higher acquisition cost and that it requires a very experienced embryologist to use it!. M&B

Words Swati Chopra Vikamsey