Presently spermatozoa for ICSI are selected based on morphology and motion, without
determining if acrosome reaction (AR) had occurred during sperm preparation or not. Although
not critical if the sperm is injected into the ooplasm, the occurrence of AR might might be
an indicator of better spermatozoon quality and implantation potential, especially in severe
OTA cases. It is impossible with conventional plain optic microscopy used in IVF units to
determine in vivo (without fixation) if AR has occurred, and as a result spermatozoa are
injected randomly. It is readily possible to distinguish AR+ from AR- spermatozoa using
polarized light microscopy due to different bifriengance.
In this study the investigators seek to determine, by a prospective RCT, if selecting only
acrosome reacted spermatozoa, in severe OTA cases, will improve the outcome of ICSI and the
entire IVF process.