IMSI does not improve pregnancy outcomes and live birth rate in severe teratozoospermia patients: a double-blind randomized controlled trial

This study was designed to evaluate the beneficial roles of the MSOME technique over × 400 magnification in terms of pregnancy outcomes, Live birth rate (LBR) and miscarriage rate in patients with severe teratozoospermia. This trial was conducted on 100 infertile couples with severe teratozoospermia who were randomly divided into ICSI and IMSI groups. Sperm DNA fragmentation (SDF) and relative sperm telomere length (r-STL) were evaluated in raw semen samples, processed samples, and selected spermatozoa at × 400 magnification in the ICSI group and by high magnification in the IMSI group. There were no statistically significant differences between the two groups in terms of DFI (F = 0.523, P = 0.515) and r-STL (F = 0.507, P = 0.565) of the selected spermatozoa after each procedure of sperm selection. No statistically remarkable differences were seen between ICSI and IMSI groups in terms of fertilization rate (67.46% vs 63.67%, P = 0.649), chemical (37.20% vs 24.44%, P = 0.194), clinical (30.23% vs 20%, P = 0.456) and ongoing pregnancy (27.90% vs 17.80%, P = 0.122), LBR (30.23% vs 15.55%. P = 0.257) and miscarriage rate (0% vs 18.18%, P = 0.332). The study concluded that the superiority of MSOME technique over × 400 magnification was not confirmed in terms of DFI and STL of selected spermatozoa, pregnancy outcomes, LBR and miscarriage rate in patients with severe teratozoospermia.