Physiological ICSI (PICSI) vs. conventional ICSI in couples with male factor: A systematic review

Abstract

ObjectivesTo determine the efficacy of the physiological ICSI technique (PICSI) vs. conventional ICSI in the prognosis of couples with male factor, with respect to the following outcome measures: live births, clinical pregnancy, implantation, embryo quality, fertilization and miscarriage rates.MethodsA systematic review of the literature, extracting raw data and performing data analysis. Patient(s): Couples with the male factor, who were subjected to in-vitro fertilization. Main Outcome Measures: rates of live births, clinical pregnancy, implantation, embryo quality, fertilization and miscarriage.ResultsIn the systematic search, we found 2,918 studies and an additional study from other sources; only two studies fulfilled the inclusion criteria for this systematic review. The rates of live births, clinical pregnancy, implantation, embryo quality, fertilization and miscarriage were similar for both groups.ConclusionThere is no statistically significant difference between PICSI vs. ICSI, for any of the outcomes analyzed in this study. Enough information is still not available to prove the efficacy of the PICSI technique over ICSI in couples with male factor.

Physiological, hyaluronan-selected intracytoplasmic sperm injection for infertility treatment (HABSelect): a parallel, two-group, randomised trial

“…Reviews and meta-analyses considering the efficacy of hyaluronan-based sperm selection for ICSI have been equivocal 5, 18, 19. Based on our study design, we can say with confidence that PICSI is not superior to standard ICSI for improving term livebirth rates, despite the reduction in miscarriage.…”

Does a microfluidic chip for sperm sorting have a positive add‐on effect on laboratory and clinical outcomes of intracytoplasmic sperm injection cycles? A sibling oocyte study

“…These methods mostly include techniques such as intracytoplasmic morphologically selected sperm injection (IMSI), magnetic‐activated cell sorting (MACS) and physiologic intracytoplasmic sperm injection (PICSI). Although some promising preliminary results have been published regarding the use of these techniques (Dirican et al, ; Kim et al, ; Worrilow et al, ), recent reviews of the relevant clinical studies were insufficient to support their benefits in terms of clinical outcomes following IVF/ICSI (Avalos‐Duran et al, ; Stimpfel, Verdenik, Zorn, & Virant‐Klun, ; Teixeira et al, ). Also, the results of a recent preclinical study reported improved ICSI outcomes through sperm selection by thermotaxis in mice (Perez‐Cerezales et al, ).…”

A scientometric analysis of research publications on male infertility and assisted reproductive technology

“…IMSI and PICSI are advanced ICSI-related techniques that are poorly studied (Avalos-Duran et al, 2018;Teixeira et al, 2020), as reflected in our scientometric results. IMSI is characterised by sperm selection based on morphological criteria under a high-resolution microscope (Kim et al, 2014;Oseguera-Lopez et al, 2019), whereas in PICSI, spermatozoa are selected using hyaluronic acid binding to mature and morphologically intact spermatozoa (Avalos-Duran et al, 2018).…”

“…IMSI and PICSI are advanced ICSI-related techniques that are poorly studied (Avalos-Duran et al, 2018;Teixeira et al, 2020), as reflected in our scientometric results. IMSI is characterised by sperm selection based on morphological criteria under a high-resolution microscope (Kim et al, 2014;Oseguera-Lopez et al, 2019), whereas in PICSI, spermatozoa are selected using hyaluronic acid binding to mature and morphologically intact spermatozoa (Avalos-Duran et al, 2018). PICSI and IMSI have not shown many benefits in reproductive outcomes over conventional ICSI, including fertilization, implantation, clinical pregnancy, miscarriages and live birth rates, as well as embryo quality (Avalos-Duran et al, 2018;Teixeira et al, 2020).…”

“…Furthermore, ICSI bypasses sperm kinetic defects, the presence of anti-sperm antibodies, acrosome dysfunction and the lack of maturity in gametes collected directly from the epididymis or testicles (Palermo et al, 2014). These findings might explain the dominant research focus on ICSI (Avalos-Duran et al, 2018;Palermo et al, 2014Palermo et al, , 2017.…”