What is PICSI?

Physiological intracytoplasmic sperm injection (PICSI) is a technique used to select sperm to use in Intracytoplasmic sperm injection (ICSI) treatment. It involves placing sperm with hyaluronic acid (HA), a natural compound found in the body. PICSI identifies sperm that can bind to HA and these sperm are selected for use in treatment.

Risks of PICSI

PICSI is a non-invasive procedure performed on a semen sample as an additional step in the ICSI process. Risks associated with the use of ICSI also apply to PICSI; there are no significant additional risks to the patient or embryo.

Evidence

Seven studies including a large RCT called HabSelect form the main published evidence. The six studies prior to HabSelect suggested no benefit to P-ICSI.

HabSelect was published in 2019 and included more than 2,700 patients needing ICSI. It showed no significant difference between P-ICSI and ICSI in terms of live birth. However it can’t rule out a small (2 to 3%) increased benefit in P-ICSI through a reduction in miscarriage. However to prove this a study would require in excess of 20,000 participants.

Current HFEA grading

For more information, please visit the HFEA website