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There is a lack of clarity regarding the justification to instruct the couple to shift from intracytoplasmic sperm injection (ICSI) to intracytoplasmic morphologically selected sperm injection (IMSI). In this study, we aim at evaluating the efficacy of IMSI in couples with previous implantation failure with ICSI.

Inclusion Criteria:

• Patients with ICSI indication, who have previously underwent >= 1 ICSI attempt in which at least 2 blastocysts were transferred, with no implantation.
• Regular menstrual cycles every 25-35 days.
• Body Mass Index less than 35 as calculated according to the following formula: body weight (kg) / height x height (m2)
• Presence of both ovaries.
• No pelvic and / or clinically significant uterine anomalies.
• Normal cervical cytology.
• Serum follicle stimulating hormone (FSH) within normal limits.

Exclusion Criteria:

• Clinically significant systemic disease.
• Infection by the human immunodeficiency virus (HIV).
• Infection by the by the hepatitis C virus
• Positive test for surface antigens of hepatitis B.
• Endometriosis stages III - IV (classification of the American Society for Reproductive Medicine).
• Hydrosalpinx, unilateral or bilateral.
• Abnormal gynecological bleeding, undiagnosed.
• Allergy or hypersensitivity to human gonadotropin preparations or any other related to the study medication.

-Simultaneous participation in another clinical trial. -