Since 2008, our group has published studies showing a relationship between spermatozoa with vacuoles and increased DNA fragmentation; as well as an association between sperm with vacuoles and abnormal chromatin packing. Based on these studies and those of other authors, we decided to consider spermatozoa with vacuoles (especially those occupying ≥50% nuclear area) as a risk cell for transporting DNA damage, and we started to use selection at high magnification (MSOME/IMSI) as a routine for ICSI cases. During these almost 15 years we have been heavily criticized for this approach based only on basic studies, especially considering the divergence in the literature regarding its efficiency versus ICSI in improving parameters traditionally used in the evaluation of any methodology in assisted reproduction (fertilization rates, clinical pregnancy , live births, etc.). In other words, we would be intensively cultivating one more of these countless adds-on.