By Cristina Mestre Ferrer BSc, MSc (embryologist).
Last Update: 04/09/2014

PICSI is a variation of the ICSI technique where the P stands for physiological.

In the traditional ICSI the selection of the spermatozoon is made by the embryologist who observes the sperm sample and selects a spermatozoon with good motility to carry out the ICSI.

By means of the physiological ICSI or pICSI it is intended to find a less subjective system in the sperm select system. This variation of the ICSI is carried out using a similar molecule that surrounds the oocyte naturally.

The different sections of this article have been assembled into the following table of contents.

Indications

This assisted reproduction technnique is rather new, so it is still being studied which patients should be the most appropriate to undergo this technique. However, fertility clinics have decided that the use of this technique is indicated in cases of:

  • Patients whose spermatozoa have a high degree of DNA fragmentation.
  • Previous ICSI failure caused by low-quality embryos.
  • In cases of repeated miscarriage where the cause might be the man’s sperm or it can be unkown.

Procedure

The pICSI procedure is the same as that of the ICSI. It only changes in the selection of the male gamete. That is why this is the part on which were are going to focus now.

The sperm collection is made as usual. After the sperm capacitation, the spermatozoa are placed in a special plate.

PICSI (Physiological ICSI)

This plate contains some drops of a synthetic material very similar to hyaluronic acid that naturally covers the oocytes. The best-quality spermatozoa will get stuck to these drops, so the embryologist will be able to easily identify them and used them for the ICSI.

Once the spermatozoon has been selected, it is aspirated with the microinjection pipette and the regular ICSI is performed.

Advantages

This method is very useful in cases of patients with sperm with good motility and a high degree of DNA fragmentation because they help to choose the mature spermatozoon with a good quality.

Advantages of PICSI

These spermatozoa are selected individually and present low rates of fragmentation which can help reduce the possibility for any genetic alterations such as aneuploidy.

In this way, the chance for good-quality embryos to form is higher which leads to a rise in the pregnancy rates.

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Authors and contributors

 Cristina Mestre Ferrer
BSc, MSc
Embryologist
Bachelor's Degree in Biological Sciences, Genetics & Human Reproduction from the University of Valencia (UV). Master's Degree in Biotechnology of Human Assisted Reproduction from the UV and the Valencian Infertility Institute (IVI). Embryologist at IVI Barcelona. More information
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