PICSI uses a special medium to which the "better" sperm adhere and uses them for ICSI.
There are first studies that suggest a better pregnancy success (Parmegiani et al. (2010a)"Physiologic ICSI" Hyaluronic acid (HA) favors selection of spermatozoa without DNA fragmentation and with normal nucleus, resulting in improvement of embryo quality. Fert. Sterile. 93,598-604). This special medium is a natural alternative to conventional media, because it consists of hyaluronate (HA), a naturally occurring substance in the cumulus complex; it has no toxic or immunological effects on sperm or eggs.
Two main factors distinguish HA from other media:
- Increased safety aspect: HA is part of the natural environment of the oocyte and is fully biodegradable.
- Qualitative sperm selection: The selection procedure of SpermSlow is based on sperm binding to HA by means of receptors on the sperm heads. Only mature sperm bind effectively, therefore it is possible to select only competent sperm with better developmental maturity and DNA integrity.
Evaluation: A scientifically sound proof is only possible after further clinical studies in the future, if necessary.
When is PICSI useful?
PICSI is recommended in the following situations:
- low number of follicles
- Women older than 38 years
- AMH value in women < 0.5 ng/ml
- 2 ICSI treatments performed without pregnancy
- If there is a significantly reduced number of sperm (cryptozoospermia) in the spermiogram