Infertile couples with severe sperm problems, have now many available technologies such as ICSI and PICSI. ICSI is the microinjection procedure that injects the sperm directly into the female egg and PICSI is the procedure to inject the best possible sperm into the egg.

During routine ICSI, spermatozoa are selected by the embryologist based on the irappearance and in the majority of patients this approach delivers very good results.

Especially for patients with a poor sperm sample or if we have only very low number of mature sperm available, PICSI can select the best sperm for injecting into the egg. By this way, embryologists are able to determine sperm selection in much the same way it happens in human biology.

PICSI was originally discovered in 2006 and by researchers at Yale University and marketed in 2008. It is a name which the letter “P” comes from the petriedish used in the process. Now, it is also used for the term “physiological” ICSI.
For the PICSI method, sperms are placed in a PICSI dish containing samples of hyaluronan, a naturally occurring biopolymer found in the layer surrounding the egg. Mature, biochemically competent sperms bind to the hyaluronan where they can be isolated by the embryologist and used for ICSI.

Hyaluronan-bound PICSI-selected sperm, in the vast majority of cases, are known to have less DNA damage and have fewer chromosomalab normalities.It is hoped that the use of the PICSI techniques hold improve pregnancy rates and reduce the number of IVF miscarriages.

Sperm identified using the PICSI technique exhibit no detect able adverse effects from the hyaluronicacid contact. 
PICSI technique as well as IMSI method is currently used in our lab to obtain the best results.


  • Parmegiani L, Cognigni GE, Bernardi S, Troilo E, Ciampaglia W, Filicori M.”Physiologic ICSI”: hyaluronicacid (HA) favors selection of spermatozoa without DNA fragmentation and with normal nucleus, resulting in improvement of embryo quality.Fertil  Steril. 2010 Feb;93(2):598-604.
  • Worrilow KC, Eid S, Woodhouse D, Perloe M, Smith S, Witmyer J, Ivani K, Khoury C, Ball GD, Elliot T, Lieberman J.Use of hyaluronan in the selection of sperm forintracytoplasmic sperm injection (ICSI): significant improvement in clinical outcomes–multicenter, double-blinded and randomized controlled trial. Hum Reprod. 2013 Feb;28(2):306-14. doi: 10.1093/humrep/des417. Epub 2012 Nov 30.
  • Parmegiani L, et al. Efficiency of hyaluronicacid (HA) sperm selection.J AssistReprodGenet. 2010 Jan;27(1):13-6. doi: 10.1007/s10815-009-9380-0. Epub 2009 Dec 30.
  • Nasr-Esfahani MH, Marziyeh T. Sperm selection for ICSI using the hyaluronicacid binding as say. Methods Mol Biol. 2013;927:263-8.

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