Physiological Intracytoplasmic Sperm Injection (PICSI) is an advanced form of ICSI that improves the process of selecting sperm before fertilisation.
In conventional ICSI, embryologists choose sperm primarily by examining their appearance and movement under a microscope. Although this approach has proven highly successful, it cannot always identify subtle functional differences between sperm cells.
PICSI introduces an additional selection step based on the sperm’s physiological maturity. During the procedure, sperm are placed in a specialised laboratory dish coated with hyaluronan, a naturally occurring substance that surrounds the egg during natural fertilisation.
Only mature sperm with the ability to bind to hyaluronan are selected for injection into the egg. This process more closely resembles natural conception and provides embryologists with additional information when selecting sperm for fertilisation.
Because PICSI is performed during an IVF cycle, it is always combined with Intracytoplasmic Sperm Injection (ICSI) rather than being used as a standalone treatment.
PICSI is not routinely recommended for every IVF patient. Instead, it is considered when sperm quality or previous treatment history suggests that advanced sperm selection may provide additional clinical benefit.
Your fertility specialist may recommend PICSI if:
Before recommending PICSI, your fertility specialist will review semen analysis results, fertility history, previous treatment outcomes, and any additional investigations required to determine whether advanced sperm selection is appropriate.
PICSI follows the same overall treatment pathway as IVF with ICSI, with one important difference, the method used to select sperm before fertilisation.
Treatment begins with a comprehensive fertility evaluation for both partners. Hormonal testing, ultrasound examinations, semen analysis, and other investigations help identify the factors contributing to infertility and guide the most suitable treatment approach.
The female partner undergoes ovarian stimulation to encourage the development of multiple mature eggs. Once the follicles have reached the appropriate stage of development, the eggs are retrieved using a minimally invasive procedure.
A semen sample is processed in the embryology laboratory before sperm selection begins.
Instead of selecting sperm solely by appearance, the processed sperm are introduced into a specialised PICSI dish containing hyaluronan. Mature sperm naturally bind to the hyaluronan, while immature or functionally compromised sperm generally do not.
The embryologist carefully selects these bound sperm for fertilisation because they demonstrate characteristics associated with physiological maturity.
Once suitable sperm have been selected, each mature egg is fertilised using the ICSI technique, where a single sperm is injected directly into the egg.
The embryos are then cultured under carefully controlled laboratory conditions while their development is monitored over several days.
The highest-quality embryo is selected for transfer into the uterus at the appropriate stage of development. Depending on your fertility diagnosis, additional laboratory techniques such as Preimplantation Genetic Testing (PGT), Laser Assisted Hatching, or EmbryoGlue may also be considered as part of your personalised treatment plan.
PICSI and ICSI are closely related procedures, but they differ in how sperm are selected before fertilisation.
With conventional ICSI, embryologists rely primarily on visual assessment under the microscope, selecting sperm based on their appearance and movement.
PICSI adds another layer of assessment by selecting sperm according to their ability to bind naturally to hyaluronan. This process helps identify sperm that have reached functional maturity before injection into the egg.
For many patients, conventional ICSI remains the most appropriate treatment. PICSI is generally reserved for situations where additional sperm selection may offer clinical advantages based on previous fertility history or sperm quality.
For carefully selected patients, PICSI may provide additional information during sperm selection and support personalised IVF treatment planning.
Potential benefits include:
Although some studies suggest that PICSI may improve certain IVF outcomes in selected patient groups, treatment success depends on many factors including maternal age, egg quality, embryo development, uterine health, and the underlying cause of infertility. For this reason, PICSI is recommended only when supported by your clinical evaluation.
Male infertility is often influenced by several factors simultaneously, meaning no single laboratory technique is appropriate for every patient.
At Nordica Fertility Centre, PICSI may be combined with other advanced reproductive technologies depending on the underlying fertility diagnosis. These may include Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) for detailed sperm morphology assessment, Microfluidic Sperm Sorting to isolate highly motile sperm, or Sperm Retrieval Procedures (TESA/PESA) for men with little or no sperm present in the ejaculate.
By integrating advanced laboratory techniques with personalised fertility care, our specialists develop treatment plans designed around each couple’s unique reproductive needs rather than applying the same approach to every IVF cycle.
Holistic fertility care that puts you first. Trusted specialists, proven track record, support at every step.
Monday – Friday : 09 AM – 4 PM [WAT]
Saturdays: 9 AM – 1 PM [WAT]
+2347026277855
+2348077716409
Copyright © 2026 All Rights Reserved