PICSI is an innovative technique, developed as an improvement of the simpler microinjection ICSI technique. It is recommended to couples with male infertility issues, thus requiring the use of ICSI, but who have in addition low sperm binding to hyaluronic acid (HBA test) or high sperm DNA fragmentation (DFI).
During ICSI, the spermatozoa are selected based on their morphology and motility. However, in this case, sperm selection is more subjective, as the embryologist selects the spermatozoon based on a visual assessment under low resolution, without having any indication on its dynamics and ability to fertilize the oocyte. On the other hand, PICSI, a physiological ICSI technique, provides sperm functionality testing, thus assisting the embryologist to select the best quality spermatozoon.
PICSI is based on the fact that mature sperm head without DNA fragmentation has a specific receptor that provides it with the ability to bind to a protein called hyaluronic acid, the main component of the oocyte's cumulous oophorous, a natural process essential for fertilization.
PICSI is particularly useful in cases of men who have:
- Low HBA indicator
- High DFI (DNA fragmentation index)
- Previous failed attempts with ICSI
- Embryo development failure in previous attempts
- Bad spermatozoa morphology
- Reduced sperm motility
- Sperm collected through the techniques of TESA or MESA
