What is PICSI?

PICSI is yet another advancement in the field of fertility treatment, albeit one that remains a subject of considerable discussion. So what is PICSI and what does it offer in the world of constantly evolving fertility treatments?

What does PICSI involve?

PICSI is a method of selecting the best possible sperm for fertilisation in the IVF protocol. If you’re wondering why this is important, the answer is simple: The better the quality of sperm the better the chances of a successful fertilisation during IVF. PICSI is based on the concept of Hyaluronan binding, Hyaluronan is more than just a particularly difficult word to spell, it is a material that you can find in most parts of your body, including around the female egg. What PICSI does is select sperm according to how well they bind to the Hyaluronan around an egg cell (called hyaluronic acid) through a test called a Hyaluronan Binding Assay.

Why is this important? Well the process of fertilisation is designed to root out weaker sperm and pick the best, so that only the most able sperm with the best genetic material makes it to the egg and fertilises it. The more mature a sperm cell, the more able it is to bind to hyaluronic acid, meaning that it is better suited to fertilising the egg. PICSI works on the basis that the better sperm are in this respect, the better they are in all other respects, including motility (their ability to move and get to an egg) and morphology (specific shape and structure needed to do a sperm’s job).

PICSI itself is a petri dish which is coated with little segments of hyaluronan. Sperm are placed in the dish, and those that bind to these hyaluronan dots are the ones that are chosen for the popular ICSI procedure, which directly introduces these sperm cells into an egg cell to fertilise it.

What are the advantages to PICSI?

Simply put PICSI is a much more refined way of picking the best sperm for fertilisation. While traditionally sperm are selected for ICSI based on their appearance, PICSI allows for this choice to be made based on the sperm’s ability to fertilise and function. Moreover the PICSI dishes are quite straightforward and easy to use. The method of selecting sperm based on their appearance is also flawed because chromosomal defects can still be found within healthy looking sperm.

What are the disadvantages to PICSI?

Currently there are no distinct disadvantages to PICSI bar the fact that its effectiveness has yet to be fully established. There are different opinions about how efficient the PICSI selection method is in increasing fertilisation rates, studies are still being conducted but the evidence so far remains scattered. While there is a clear link between the ability of sperm to bind to hyaluronic acid and that sperm’s motility and morphology, there isn’t a clear link between that ability and improved fertilisation rates in IVF.

If you are interested in PICSI then it’s always worth talking to your doctor about it. There are alternatives to PICSI in terms of sperm selection, the most notable of which is probably IMSI, a method using a high powered microscope to select the best available sperm for the job.

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