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PICSI/IMSI

In particularly severe cases of male infertility, IVF procedure is undertaken with PICSI

Indications

ICSI can be included in the program given male infertility and in a number of other situations when unassisted insemination is invariably impossible. Under which circumstances do Life Line reproductologists recommend PICSI procedure over ICSI?

bad sperm morphology (teratozoospermia);
absence of conception with normospermia in the partner;
failed ICSI-IVF treatment attempts in the past.

PICSI in details

Modern reproductive technologies tackle the most severe factors of infertility. When sperm cannot permeate an egg, the conventional IVF program is ineffective. However, the problem can be solved if the IVF program is supported by ICSI (intracytoplasmic sperm injection, when an embryologist injects sperm into an oocyte with a special needle). In particularly severe cases of male infertility, IVF is performed with the help of the PICSI procedure. It is still an ICSI technique but supported by an extra phase of sperm selection. Its purpose is to select the most prospective sperms with the greatest degree of accuracy possible. PICSI procedure increases the chances for effective sperm selection up to 98%. 

Why Life Line care center is the best choice for IVF with PICSI?

Inclusion of PICSI method into an in vitro fertilization program allows for desirable pregnancy regardless of serious sperm quality issues. However, this technique is high-tech and extremely exacting. It requires the employment of the newest laboratory supplies and medical equipment. The subsequent procedure of intracytoplasmic sperm injection into an egg requires the finest possible work of the embryologist with extensive experience in the procedure implementation. In Life Line embryology laboratory all these conditions meet. That is why our specialists can report remarkable results achieved in our clinics in national and international professional forums. 

PICSI procedure in detail

PICSI (Physiologic Intra Cytoplasmic Sperm Injection) is the assisted reproduction technique that is employed as a part of IVF programs. What is the difference between PICSI and ICSI?

  • During a conventional IVF program, the conception process is undertaken via in vitro sperm-egg interaction where sperm penetrates the egg without any assistance. 
  • During IVF with ICSI, the embryologist selects the best sperm with a microscope, estimates its morphology and motility and, then, using special needle helps the best one to pull through the egg’s membrane to inject it inside.
  • During IVF with ICSI, the selection procedure is undertaken via electron microscope and is based on a physiological mechanism. All the other aspects are the same as during an ICSI cycle.

Sometimes another question can arise: what is the difference between PICSI and IMSI? 

The difference here is of another type. IMSI is an outdated procedure which can be considered to be a PICSI’s predecessor. It used to be the one employed as an additional phase to ICSI so that the selection process of morphologically healthy sperms could be improved. 

During IMSI the selection procedure is undertaken with the only help of a high-magnification microscope, as it is done in ICSI. The practice has shown that this technique is not that effective. With the dissemination of PICSI program where gamete cell structure assessment is performed in a more advanced manner, IMSI has started receding into the past. IMSI procedure is not implemented in our center. 

Why undertake extra procedures?

Sometimes it is not enough to visually estimate sperm functioning and its fertility even via the best high-magnification microscope. Only mature sperms with well-developed receptors are able to conceive an oocyte. However, it is not always possible to differentiate between mature and immature sperms by eye. This happens because immature sperm can possess high motility and good structure as well. That is the reason for the necessity of a more thorough selection procedure that can be performed via PICSI. 

How PICSI procedure is performed in Life Line care center?

An embryologist places just harvested or thawed sperms into hyaluronic acid. There is a particular reason for the employment of this special natural substance during the procedure – it is one of the components of the egg membrane structure. Mature quality sperms are connected with hyaluronic acid during PICSI procedure, unlike immature ones. Subsequent procedures are undertaken according to an ICSI standard plan. An embryologist with a special pipette captures the best sperm (that showed a sought-for reaction to hyaluronic acid), immobilizes it and very gently injects it into an egg cell’s cytoplasm thereby enabling conception process. The process is monitored through an electron microscope. All the other aspects are the same as during a natural IVF cycle.


Under what circumstances in vitro fertilization with PICSI can be recommended? 

Our experience shows that for certain patient categories PICSI procedure included into in vitro fertilization program increases the chances for development of healthy embryos with high potential for implantation. There are some examples in the Life Line specialists’ practice showing that IVF with PICSI had a successful outcome with those couples whose chances for pregnancy had earlier been estimated as hopeless. However, it is important to remember that the effectiveness of the technique can be guaranteed only on specific medical grounds. Only a reproductologist can determine whether a couple should be recommended with the PICSI procedure, or not. The decision is made after analysis of the examination results, studying the previous infertility treatment attempts and a conversation with patients.

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