Rated black for increasing the chances of having a baby for patients having ICSI due to male factor infertility

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 test performed on a semen sample as an additional step in the ICSI process. The risks associated with the use of ICSI also apply to PICSI.

Evidence

PICSI has only been studied in patients undergoing ICSI due to male factor infertility, and there is no benefit to having PICSI where treatment is not due to male factor infertility. There have been several studies comparing PICSI with standard ICSI for patients undergoing ICSI for male factor infertility and one high quality large RCT was carried out which showed that using PICSI did not increase the chances of having a baby.

The results of this large RCT did suggest that PICSI may be beneficial in reducing the chance of miscarriage. However, it is important to keep in mind that this evidence was a secondary outcome, this means that the study was not designed to investigate the effect of PICSI on miscarriage rate, making these secondary results less reliable. For this reason, it is important to discuss your individual circumstances with your doctor.

Aria’s view

While we are able to perform PICSI at Aria this ad-on is not something we routinely recommend to patients. At Aria, we can test the binding properties of sperm to HA to determine if P-ICSI could offer a benefit in selecting sperm. We do this on the sample produced on the day. Hyaluronan binding assay (HBA) allows embryologists to distinguish between mature sperm that express hyaluronan receptors (key for egg-sperm recognition) and those that do not. If after this assessment we suspect that the sperm quality may be compromised, then P-ICSI will be discussed with you. Please contact our Patient Services team to enquire about this assay.