PICSI

🧬 What is PICSI (Physiological ICSI)?

PICSI stands for Physiological Intracytoplasmic Sperm Injection. It is an advanced sperm selection method used before performing ICSI. In this technique, only mature, functionally competent sperm are selected using a hyaluronic acid (HA) binding test.

This is important because hyaluronic acid is naturally found around the egg, and only mature sperm can bind to it. These selected sperm are less likely to have DNA damage, making them ideal for injection during ICSI.

🧠 Why is PICSI Done?

PICSI is used to improve the quality of sperm selection, especially in patients with:

Recurrent IVF or ICSI failure
Recurrent miscarriages
High sperm DNA fragmentation

Poor embryo quality in past cycles
Advanced paternal age
Unexplained infertility

🔍 How PICSI Works: Step-by-Step Process

1. Sperm Sample Collection

A semen sample is collected from the male partner (either naturally or via surgical retrieval like TESA/PESA).

2. Sperm Preparation

The sample is washed and processed using standard techniques.

3. PICSI Dish Preparation

A special PICSI dish is used, which contains hyaluronic acid microdots.

4. Sperm Interaction with Hyaluronic Acid

The prepared sperm sample is placed in the PICSI dish.
Only mature, biochemically competent sperm will bind to the hyaluronic acid microdots.

5. Sperm Selection

The embryologist selects only the sperm that are bound to HA, as these are more likely to have normal morphology, motility, and DNA integrity.

6. ICSI Procedure

These selected sperm are then injected into the mature eggs using standard ICSI technique.

📊 Benefits of PICSI

Benefit	Description
🧪 Improved Sperm Quality	Reduces risk of injecting immature or DNA-damaged sperm
👶 Better Embryo Quality	Leads to higher chances of healthy embryo development
❤️ Lower Miscarriage Risk	Selecting DNA-intact sperm may lower risk of early pregnancy loss
📈 Improved Pregnancy Rates	Especially helpful in patients with prior IVF/ICSI failures

⚖️ PICSI vs. ICSI: Key Differences

Feature	ICSI	PICSI
Sperm Selection	Based on appearance & motility	Based on natural sperm maturity
DNA Fragmentation	May go undetected	Reduces risk by selecting mature sperm
Miscarriage Risk	Slightly higher in some cases	Lower in selected patients
Extra Cost	Lower	Slightly higher

🧬 Is PICSI Right for You?

PICSI is especially recommended if:

You’ve had multiple failed IVF/ICSI cycles
You or your partner have high DNA fragmentation index (DFI)
You’ve experienced recurrent implantation failure
There is male factor infertility (low count, motility, morphology)

📌 In Summary:

Aspect	Details
Full Name	Physiological Intracytoplasmic Sperm Injection
Main Purpose	Selection of mature, DNA-intact sperm before ICSI
Used in	IVF/ICSI cycles
Best For	Recurrent IVF failures, male infertility, high DFI
Goal	Better embryo quality, higher pregnancy success, fewer miscarriages