Physiological ICSI (PICSI)
PICSI is a method which helps to choose the best sperm for ICSI.
What is PICSI?
PICSI, or Physiological ICSI, is a modified form of the ICSI procedure that may benefit a subset of patients who require ICSI.
Men with poorer sperm samples often have a greater degree of immature sperm. Immature sperm can still show normal motility and morphology, however they have higher levels of damaged DNA, which, if selected for fertilisation can result in poor embryo quality and pregnancy loss. PICSI is a method that enables us to select mature sperm for injection.
Your Clinician will guide you as to whether PICSI may be appropriate for you. There are no additional risks in using sperm selected by this method.
When is PICSI required?
ICSI and PICSI are treatments indicated for Male Factor infertility in the following cases:
- When the HBA score at semen assessment is less than 65%, indicating a reduced level of mature sperm within the sample.
Evidence from the scientific literature indicates that couples with recurrent pregnancy loss or those with slow or poorly developing embryos may also benefit from PICSI.
PICSI can also be performed at patient request and upon recommendation by one of our Fertility Specialists.
We understand that some men may have difficulties providing a semen sample under clinical conditions. Please let us know in advance, and we may recommend producing a sample for freezing ahead of the egg collection or to bring a sample from home on the day of egg collection.
During PICSI, the embryologist is able to distinguish between mature sperm which have completed their full development and immature sperm which are more likely to have damaged DNA or the wrong number of chromosomes.
The Embryologist will therefore only use mature sperm to inject directly into mature eggs. Following the PICSI, the injected eggs are incubated overnight and assessed the following morning for evidence of fertilisation. The average fertilisation rate following PICSI is similar to ICSI and IV, with 60-70% of injected eggs fertilising normally following PICSI.
