PICSI

In PICSI, a special medium is used to which the "better" sperm cells adhere and these are used 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. Steril. 93,598-604). The 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 spermatozoa or oocytes.

Two main factors distinguish HA from other media:

• Increased safety aspect: HA is part of the oocyte's natural environment and is completely biodegradable.
• Qualitative sperm selection: SpermSlow's selection process is based on sperm binding to HA by means of receptors on the sperm heads. Only mature spermatozoa bind effectively, therefore it is possible to select only the competent spermatozoa with better developmental maturity and DNA integrity.

Valuation: A scientifically valid proof is only possible after further clinical studies in the future, if necessary.

When is PICSI advisable?

PICSI is recommended in the following situations:

• low follicle count
• Women older than 38 years
• AMH value of the woman < 0.5 ng/ml
• 2 ICSI treatments have been carried out without achieving a pregnancy
• Presence of a significantly reduced sperm count (cryptozoospermia) in the spermiogram