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A meta-analysis published in RBMOnline (Edson Borges Jr, 2010), one of the most prestigious fertility magazines, confirmed that IMSI (Intracytoplasmatic morphologically selected sperm) significantly increased the top-quality embryos, implantation and pregnancy rates when compared to ICSI. Moreover the miscarriage rate was also significantly lower in this group. No difference was observed in fertilization rates. These benefits were attributed to a positive effect of the DNA of the sperm selected, either because IMSI improved the morphology of the selected sperm or because it was easier to choose a sperm not containing nuclear vacuoles.

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