New Sperm Selection Techniques (IMSI, PICSI) To Select Healthy Sperm

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New Sperm Selection Techniques (IMSI, PICSI) To
Select Healthy Sperm
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• It is estimated that 15 of couples seek help to
  overcome infertility problems.
• One-third of infertility problems are caused by
  the male factor.
• The remaining two-thirds are women-related
  problems and unclear causes and appear to be
  evenly distributed between male and female
  components.
• Assisted reproductive technology (ART) is used in
  approximately 2-4 of births.

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• Spermatogenesis methods, in particular, attempt
  to replicate in vitro the natural process by
  which viable sperm cells are separated from other
  ejaculate components as they actively migrate
  through the cervical mucus.
• Viable sperm cells are separated from other
  components of the ejaculate as early as possible
  during the laboratory procedure.

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• To select sperm cells, sperm isolation or
  isolation methods are available.
• Conventional techniques, such as simple washing
  methods, density gradient centrifugation (DGC),
  swim-up, swim-down, and glass wool filtration,
  select sperm cells based on motility and
  morphology.
• However, none of these conventional methods can
  assess important factors that affect the
  fertilizing ability of sperm, such as oxidative
  stress and DNA integrity.

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• Consequently, several advanced sperm selection
  techniques were developed to select sperm with
  high DNA integrity to improve ART success rates.
• Several of these techniques are currently in use
  for this purpose, each relying on different
  characteristics to select the best sperm.

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Physiological intra-cytoplasmic sperm injection
(PICSI)

• This method is based on the fact that hyaluronic
  acid (HA) is important for the selection of
  functionally competent spermatozoa during
  fertilization.
• HA is a major component of the cumulus matrix
  surrounding the human oocyte but is also a
  natural selector of developmentally mature sperm.
• Currently, two options are available to perform
  this technique either using plastic culture
  dishes with HA hydrogel microdots or using an
  alternative HA-containing adhesive medium known
  as "sperm slow".

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Intracytoplasmic morphologically selected
injection (IMSI)

• According to research, sperm classified as
  morphologically "normal" at standard optical
  resolution and magnification (x200-x400) may have
  ultrastructural defects.
• Many of these anomalies have been linked to
  hidden chromosomal defects, excessive DNA
  fragmentation, abnormal centriolar function, and
  other factors.
• These anomalies can obstruct fertilization, cause
  post-fertilization arrest, or even disrupt embryo
  development.

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• To overcome the aforementioned shortcomings,
  observations can be made using an inverted light
  microscope with high-power optics at x6000-x6600
  magnification, allowing embryologists to assess
  sperm morphology in real-time.
• In this regard, IMSI is beneficial for patients
  (men with low numbers, low motility, and
  increased abnormalities in their sperm samples)
  as well as couples experiencing repeated
  implantation failure or miscarriage.

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Conclusion

• Several sperm selection methods are available to
  process sperm for use in ART.
• Each infertile couple must be thoroughly examined
  to determine the best method of sperm
  preparation.
• It is the IVF clinic's responsibility to select
  cases that will benefit from these methods, as
  their routine use in all cases can have negative
  consequences.