Ghyass Jutt: Standard ICSI vs. Physiological ICSI
Ghyass Jutt, Embryologist at Sakina International Hospital at the Andrology Institute of Pakistan (STAR ICSI), shared on LinkedIn:
“Standard ICSI (PVP) vs. Physiological ICSI (SpermSlow): Mechanical vs. Biological Selection
In clinical embryology, selecting the optimal sperm for microinjection directly impacts fertilization potential and embryo development. Here is how conventional PVP compares to SpermSlow (Hyaluronic Acid):
PVP vs. SpermSlow (HA)
Standard ICSI (PVP): Relies on a synthetic polymer (7%–10% Polyvinylpyrrolidone) to increase fluid viscosity. It mechanically slows sperm motion, allowing selection based purely on motility and visual appearance-without assessing biochemical maturity or DNA integrity.
Physiological ICSI (SpermSlow): Utilizes Hyaluronic Acid (HA), a natural compound surrounding the human oocyte.
Sperm bind to HA only if they have reached full physiological maturity and expressed functional HA surface receptors.
4-Step PICSI Workflow
- Droplet Setup: Sperm sample and SpermSlow (HA) droplets are placed adjacently under oil.
- Interface Crossing: Motile sperm swim into the SpermSlow drop interface.
- Receptor Binding: Mature sperm attach to the HA matrix via functional surface receptors.
- Targeted Selection: Bound sperm lose forward motion while tail flicking continues, signaling biochemical maturity and DNA integrity for microinjection.
Clinical Advantages of PICSI
- Lower DNA Fragmentation: Favors sperm with intact DNA and reduced aneuploidy rates.
- Biocompatible: Uses a physiological medium rather than synthetic chemical polymers.
- Better Development: Supports improved blastocyst quality and clinical outcomes in targeted ICSI cases.
- What are your thoughts on implementing routine PICSI versus conventional ICSI in daily lab practice?”
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