PICSI - IMSI
PICSI is a new method of sperm selection for ICSI (intra-cytoplasmic sperm injection). It was originally developed at the University o f Yale and we have been applying it for quite some time now in our embryology lab at Gennima IVF. PICSI is used to select for mature and structurally sound sperm.
Embryologists select sperm for ICSI based on the international morphology and mobility criteria. When performing PICSI, sperm is selected by adding it to a special lab dish coated with hyaluronan. According to research, mature and structurally sound sperm will bind to hyaluronan. Sperm binding to hyaluronan has been suggested to have fewer chromosomal anomalies and lower DNA-fragmentation index (DFI). By selecting sperm this way, our goal is to create better quality embryos, ie embryos with a better chance for implantation and pregnancy achievement.
PICSI is suitable for patients with high DFI.
IMSI (Intracytoplasmic Morphologically Selected sperm Injection) is a new method for the more challenging male infertility cases. Sperm for ICSI is selected using a high-resolution microscope according to morphological criteria. The embryologist could spend 2-3 hours trying to select the best sperm. IMSI is believed to be better than just ICSI for certain patients as it allows for more detailed sperm selection. It is supposed to offer an advantage for sperm with poor morphology. Morphology has been associated with the potential for better quality embryos and ultimately with higher pregnancy rates.
Clinically, IMSI seems to make sense for couples with
· poor sperm morphology,
· low fertilization rate or low quality embryos because of low sperm quality,
· previous failed IVF cycles,
· history of biochemical pregnancies or miscarriages.
The potential benefit of IMSI for these couples could be fewer biochemical pregnancies and miscarriages and more clinical pregnancies.