{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T20:10:21Z","timestamp":1774469421822,"version":"3.50.1"},"reference-count":60,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In the field of male infertility, when sperm is normal\/subnormal, a few \u201cadd-on\u201d routine tests can complete the basic semen examination.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>The aim of this study was to develop and evaluate a faster, simplified motile sperm organelle morphology examination (MSOME) technique for selected infertile patients with apparently normal\/subnormal sperm and, in their background: failure of two or three intrauterine insemination (IUI) cycles, repeatedly fragmented embryos, embryonic development to blastocyst-stage failures, repeated miscarriages, a long period of infertility or 2 or more IVF attempts without pregnancy.<\/jats:p>\n<jats:p>Our test results were correlated with IUI, conventional <jats:italic>in vitro<\/jats:italic> fertilization (IVF), intracytoplasmic sperm injection (ICSI) and intracytoplasmic morphologically selected sperm injection (IMSI) outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>We validated an adapted version of the MSOME analysis called the pre-IMSI test (PIT), based on vacuole evaluation alone. 248 infertile patients from our assisted reproductive technology (ART) Center were retrospectively selected and split into three PIT score subgroups (patients with \u22648% (score I), 9 to 15% (score II) and \u226516% normal spermatozoa (score III)) based on the correlation between PIT results and each ART technique outcome. The choice of one or another of these ART techniques had been made according to the usual clinico-biological criteria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Clinical outcomes for each of the three PIT subgroups were compared individually for the different ART techniques. For ICSI, the effect of the PIT score subgroup was significant for clinical pregnancies (p = 0.0054) and presented a trend for live births (p = 0.0614). Miscarriage rates of IVF attempts were statistically different depending on the PIT score (p = 0.0348). Furthermore, the odds ratios of clinical pregnancy rates were significantly different according to PIT score subgroup when comparing ICSI <jats:italic>vs<\/jats:italic>. IMSI or IVF <jats:italic>vs<\/jats:italic>. ICSI attempts.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>IMSI appears to be recommended when sperm belongs to PIT score I, ICSI when it belongs to PIT score II and IVF or IUI when sperm is of PIT score III quality in selected infertile couples. The lack of statistical power in these PIT subgroups means that we must remain cautious in interpreting results.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our results support the interest of this simplified test for certain couples with normal\/subnormal sperm to help choose the most efficient ART technique, even as first-line treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0307080","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T17:27:27Z","timestamp":1721064447000},"page":"e0307080","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["First-line infertility treatment in normal or subnormal sperm: Interest of a simplified pre-IMSI test"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0940-8670","authenticated-orcid":true,"given":"Julien","family":"Sigala","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Poirey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julien","family":"Robert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1865-5542","authenticated-orcid":true,"given":"Olivier","family":"Pouget","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thibault","family":"Mura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Huberlant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathalie","family":"Rougier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"19","key":"pone.0307080.ref001","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1056\/NEJMoa003005","article-title":"Sperm Morphology, Motility, and Concentration in Fertile and Infertile Men","volume":"345","author":"DS Guzick","year":"2001","journal-title":"N Engl J Med"},{"issue":"5","key":"pone.0307080.ref002","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1093\/humupd\/dmt021","article-title":"Motile sperm organelle morphology examination (MSOME) and sperm head vacuoles: state of the art in 2013","volume":"19","author":"A Perdrix","year":"2013","journal-title":"Hum Reprod Update"},{"issue":"4","key":"pone.0307080.ref003","doi-asserted-by":"crossref","first-page":"412","DOI":"10.5534\/wjmh.200128","article-title":"Sperm DNA Fragmentation: A New Guideline for Clinicians","volume":"38","author":"A Agarwal","year":"2020","journal-title":"World J Mens Health"},{"issue":"4","key":"pone.0307080.ref004","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1093\/humrep\/dey038","article-title":"Accuracy of human sperm DNA oxidation quantification and threshold determination using an 8-OHdG immuno-detection assay","volume":"33","author":"S Vorilhon","year":"2018","journal-title":"Hum Reprod"},{"issue":"5","key":"pone.0307080.ref005","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S1472-6483(10)60308-2","article-title":"Blastocyst development after sperm selection at high magnification is associated with size and number of nuclear vacuoles","volume":"17","author":"P Vanderzwalmen","year":"2008","journal-title":"Reprod Biomed Online"},{"issue":"5","key":"pone.0307080.ref006","doi-asserted-by":"crossref","first-page":"1616","DOI":"10.1016\/j.fertnstert.2008.08.088","article-title":"A new real-time morphology classification for human spermatozoa: a link for fertilization and improved embryo quality","volume":"92","author":"NG Cassuto","year":"2009","journal-title":"Fertility and Sterility"},{"issue":"1","key":"pone.0307080.ref007","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.ejogrb.2010.01.004","article-title":"Comparison of day 2 embryo quality after conventional ICSI versus intracytoplasmic morphologically selected sperm injection (IMSI) using sibling oocytes","volume":"150","author":"AL Mauri","year":"2010","journal-title":"European Journal of Obstetrics & Gynecology and Reproductive Biology"},{"issue":"4","key":"pone.0307080.ref008","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1016\/j.fertnstert.2012.12.025","article-title":"Novel technologies for selecting the best sperm for in vitro fertilization and intracytoplasmic sperm injection","volume":"99","author":"D. 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