PICSI

ICSI IMSI PICSI Assisted hatching – AH MESA/TESE

PICSI is a method of sperm selection intended for ICSI. It imitates the natural linkage of mature sperms on cumulus oophorus of the oocyte in the in vitro fertilization process.

The main part of cumulus oophorus (cell layer surrounding the oocyte) is hyaluronan, which is a protein on which mature sperms are linked through hyaluronan-specific receptors. Those receptors are only on the head of a mature sperm. Immature sperms do not have receptors and therefore can not be linked. Thereby, sperms with a normal frequency of chromosomal aneuploids and sperms without fragmented DNA bind themselves on the oocyte in a natural process of fertilization. Therefore, the sperm with the best genetic information is naturally selected.

In the selection process of PICSI, hyaluronan is contained in the gel on the bottom of Petri dish. To this gel a medium with sperms is added. Sperms migrate to the gel and mature sperms are linked through receptors on the hyaluronan in the gel. This is shown by their being “stuck” by the head to the bottom of the dish, but the energetic movement of the flagellum does not stop (movement in place). Immature sperms penetrate through the gel and embody a continuously progressive movement. Linked sperms with intensive movement of the flagellum are then chosen and used in the classic process of ICSI.

PICSI indication:

  • Hard oligozoospermia and/ or teratozoospermia (≥95% of pathological sperms)

  • Low percentage of fertilized oocytes (<30%) or not fertilized oocytes after ICSI

  • Repeated abortions and/ or repeated ET without implementation