For individuals or couples attending our One-Stop Fertility Assessment, the Herts & Essex Fertility Centre has introduced an additional specialist sperm selection technique called Hyaluronan Binding Assay (HBA) analysis. The HBA semen analysis is included at no extra cost for all patients within our standard semen analysis.
The HBA sperm analysis assesses an ejaculated semen sample to determine the proportions of mature sperm with intact DNA verses those sperm which are immature and have damaged DNA. Hyaluronan itself is a naturally occurring substance which can be found within the cells that surround a female’s egg. The ability of sperm to bind to hyaluronan therefore has implications for fertilisation. Mature sperm will have developed receptor sites which mean they can bind to the hyaluronan to initiate fertilization of the egg, whereas immature sperm lack these receptors and would be unable to bind.
A normal HBA analysis is recorded when at least 65% of the ejaculated sperm within a sample exhibit HBA binding. The HBA test can therefore be used alongside a standard semen analysis to identify those men with increased proportions of immature sperm with damaged DNA within their sample.
What does HBA sperm analysis mean for you?
By identifying those males, often with lower sperm concentrations, who have more than 35% immature sperm within their semen sample, we are able to offer an alternative to conventional Intra-Cytoplasmic Sperm Injection (ICSI) to improve their chances of success, called PICSI.
What is PICSI?
PICSI stands for Physiological Intra-Cytoplasmic Sperm Injection. PICSI uses a method of sperm selection to distinguish between those sperm which are mature from those which are immature. Mature sperm with intact DNA will bind to a hyaluronan coating on a specialised ICSI dish and can be selected and used for PICSI. There are no additional risks in using sperm selected by this method over conventional ICSI.
As immature sperm can still show normal movement (motility) and exhibit a normal appearance (morphology) under the microscope, only by carrying out PICSI can we be confident to ensure that those sperm which are immature are deselected. We know that because these immature sperm have higher levels of damaged DNA, they can result in poor embryo quality and pregnancy loss.
Can PICSI still benefit me if I have a normal HBA analysis?
Unless all sperm bind to the hyaluronan coated slide during the HBA analysis, all patients regardless of their HBA score can potentially benefit from the PICSI procedure. Although PICSI research has focused primarily on the semen samples of those men with 35% or greater immaturity, as these sperm cannot be distinguished from mature sperm on the basis of their movement or appearance, there is still the chance that sperm with associated DNA damage can be selected for injection with ICSI.
How to find out more?