PICSI (physiological intracytoplasmic sperm injection)
PICSI refers to a method in which hyaluronic acid is used in sperm selection, in order to distinguish immature from mature sperm. This enables a higher quality of sperm to be selected for ICSI (injection of sperm into the egg cell). The heads of mature sperm carry a specific receptor for hyaluronic acid, while immature sperm do not. Mature, mobile sperm bind head-first to the hyaluronic acid spots in the tissue culture dish. This stimulates the binding of the sperm to 60 the egg, as hyaluronic acid is an essential component of the egg membrane. This hyaluronic acid binding test selects sperm that have reached a certain stage of maturity and which, according to study results, have a low proportion of changes in their chromosomes. Normally 96% of sperm have their chromosomes intact, while only 4% of sperm show changes that may negatively affect egg fertilisation. However, this overall still reduces the chances of fertilisation. PICSI increases the proportion of chromosomally healthy, mature sperm. We consider the PICSI method to be a more natural and effective form of fertilisation compared to the classic ICSI method. PICSI combines the advantages of spontaneous fertilisation, in which the mature sperm fertilises the egg, along with the advantages of the ICSI method, when the sperm is injected directly into the egg in a controlled environment. This method can be used for all patients and is recommended especially in the following cases: previously failed implantation, low fertilisation rate after ICSI, abnormalities in embryo quality or delay in their development, repeated miscarriages or patients with a largely increased proportion of abnormal sperm.
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