What is PICSI?
PICSI (Physiological ICSI) is a new micro-manipulative technique for identifying healthy, functional sperm for injection into mature egg, improving the chances of successful fertilization and also reduces the miscarriage risk.
How does PICSI influence IVF success rates?
PICSI increases the success rate by approximately 20% because it enables us to select and introduce a sperm to the oocyte based on its functional quality. This method works on the same principle by which sperms are selected in a woman’s body during the natural fertilization process.
When is PICSI Recommended?
This method is recommended in cases in which:
- Sperm defect is suspected, for example sperm immaturity, chromosomal anomaly, a high degree of DNA fragmentation.
- Low or poor fertilization with ICSI has occurred.
- Poor embryo quality has been found.
- Previous history of repeated implantation failure.
- Repeated miscarriage has occurred.
PICSI is not feasible in patients for whom we aspirate sperms from the testis where most sperms are not motile and patients with ≤ 1million motile sperms in the final sample preparation.
What is difference between ICSI and PICSI?
During ICSI, motile sperms are selected for injection, based on their morphology and motility. This does not guarantee the introduction of a sperm with the optimum genetic package.
PICSI is a more refined procedure where we are able to determine sperm selection based on their function and it is similar to the process of sperm selection that happens during natural fertilisation. The selected sperm will have good DNA integrity and less incidence of DNA fragmentation.
What is PICSI procedure?
The PICSI procedure is the same as that of the ICSI, the only change being the method of selection of the male gamete.
The embryologist uses a PICSI dish, which is coated with drops of hyaluronan hydrogel. Hyaluronan is a naturally occurring bio polymer found in all human cells, including the gel layer surrounding the oocyte. The best – quality mature spermatozoa will get stuck to these hyaluronan and shows tails with hyper activation. Sperm showing this type of activation will be chosen for ICSI.
Once the spermatozoon has been selected, it is aspirated with the microinjection pipette and the regular ICSI is performed.