ABSTRACT
Intracytoplasmic sperm injection (ICSI) introduced more than 20 years ago was a tremendously helpful tool to overcome the infertility of couples when conventional in vitro fertilization (IVF), partial zona dissection, or subzonal sperm injection treatments had failed [1]. The injection of a single spermatozoon into the ooplasm provided an apt answer to severe male infertility diagnosis indicated by low sperm count, poor sperm motility, or both, or to infertility due to morphology deciency. Interestingly, since the introduction of ICSI, less attention has been devoted to the sperm’s morphology in itself. In addition, it is even more remarkable that after the introduction of ICSI, even though human spermatozoa exhibit a wide range of shapes, several studies found no correlation between the injection of sperm with normal or abnormal morphology and ICSI outcomes [2,3]. However, such observations were most probably biased by the selection performed by the embryologist who tried to select the best “normallooking” motile spermatozoa before ICSI, which does not always reect the quality of the whole semen population.
