Intracytoplasmic sperm injection (ICSI+PICSI)
Intracytoplasmic sperm injection (ICSI) is the most commonly used micromanipulation technique in IVF infertility treatment. It is the first choice method of fertilization of the egg in the treatment of male factor infertility, as well as other indications. In ICSI, the embryologist selects a single sperm, which is sucked into a micropipette and injected directly into the cytoplasm of the egg. The criterion for sperm selection in ICSI is the morphology of the sperm and the nature of its movement.
Preselected ICSI (PICSI) is a method of selecting the ideal sperm for microinjection based on a similar principle to what happens in the human body. The sperm are injected onto a dish covered with a layer of hyaluronan hydrogel. It is a biopolymer that is found in the egg’s envelope. Mature, biochemically competent sperm bind to the hyaluronan and are selected by the embryologist for ICSI. Research has confirmed that sperm selected by hyaluronan binding are more mature, show fewer DNA breaks and less chromosomal aneuploidy.
Indications for ICSI and PICSI
In men
- low sperm count (oligospermia)
- low percentage of motile sperm (asthenospermia)
- high percentage of sperm with abnormal shape (teratozoospermia)
- absence of sperm in the ejaculate (azoospermia)
- antibodies to sperm present
- fertilization failure occurred in the previous cycle
In women
- with a low number of eggs retrieved
- with low egg quality
- diagnosed with endometriosis
- age over 35 years
