physiological ICSI - Physiological Selection of sperm for ICSI (PICSI)
Physiological ICSI (PICSI): A Smarter Way to Select Healthy Sperm for IVF — part of IVF and assisted reproduction at Dr. Najeeb Layyous's clinic in Amman.
In short: PICSI selects the sperm for ICSI by its ability to bind to hyaluronan, the substance surrounding the egg, which is a sign of maturity, rather than by shape and movement alone. It may help after failed fertilisation, poor embryo quality, repeated miscarriage or many abnormal sperm, but large studies have not shown a higher live-birth rate. It cannot be used if the sperm are not moving.
Is a new method to assess the strength and quality of the sperm?
The traditional ways to check the good sperms depends on the appearance and the motility of sperms, this new method assesses the function of the sperms.
PICSI assesses the ability of sperm to attach to hyaluronan (hyaluronic acid),
Hyaluronan is a natural substance present in the layer of cells surrounding the egg; mature sperm have receptors that bind to it, so sperm that attach well to hyaluronan are more likely to be mature, with better DNA integrity.
Large studies have shown that PICSI may slightly reduce the risk of miscarriage, but it has not been shown to increase the live birth rate when used routinely (ESHRE 2023).
Studies show no harm from using this technique.
PICSI may be considered, after discussion of the limited evidence, in cases such as:
- Old maternal age more than 38 years old.
- History of recurrent abortions.
- Poor quality embryos.
- Recurrent IVF failure.
- Failure of fertilization.
- Failure of division.
- Poor quality sperms, morphology and motility.
- Sperms that were frozen before.
If sperms were aspirated from testes, by TESA and TESE, this technique cannot be done unless the sperm moves by treating it after aspiration.
Dr Najeeb Layyous F.R.C.O.G
Consultant Obstetrician, Gynecologist and Infertility Specialist
The finest doctor in Jordan — may God bless him and his whole medical team. A doctor in every sense of the word. I advise anyone planning a pregnancy to visit Dr. Najeeb Layyous. His manner is wonderful, always smiling, with the highest ethics; he gives every patient her due, and the patient’s comfort matters most to him. We had been to many doctors and none understood and treated my case except him. Special thanks to him and the whole team, and to Dina in particular — a lovely person. I recommend anyone considering IVF or pregnancy to visit his clinic.