Ever since Nobel laureate Robert Edwards discovered in vitro fertilization (IVF. In vitro fertilization) to help infertile couples overcome their problems, scientists have continued to develop this method to improve it. Classical IVF is still a fairly common procedure according to European registries of assisted reproductive technologies, but now, if there is a medical indication, the patient can use two new techniques: ICSI (intracytoplasmic sperm injection) and PICSI (physiological intracytoplasmic sperm injection). Let’s find out more about each of them.
There are many cases of infertility caused by combined (male and female) or only male factors of infertility. This means that the sperm in such patients are affected by a pathological process and may contain genetic problems or be of a pathological form, mobility. In classical in vitro fertilization, clinical embryologists cultivate oocytes together with spermatozoa for a certain period of time, in some cases this can lead to negative consequences.
For example, a situation is possible when a morphologically or genetically bad spermatozoon fertilizes an oocyte. Occasionally, situations arise when more than one sperm is involved in the fertilization process. In both situations, this can lead to genetic abnormalities in the embryos, which can be expressed in congenital anomalies or diseases of the future fetus.
The methods listed above can be used to prevent this. They are very similar, but let’s understand the main thing: this is fertilization, produced and controlled directly by the embryologist. The oocytes of the donor or suspected biological mother are placed in drops of a special medium, and the sperm are placed in a separate medium inside the same laboratory dish. Under the inverted microscope, which is built into the ICSI station, your clinical embryologist selects the best spermatozoa according to the morphological quality assessment and “injects” them, using a system of micromanipulators into the oocyte cytoplasm, one sperm in one oocyte. This procedure is non-traumatic for oocytes due to the plasticity of the cells and prevents abnormal fertilization by more than one sperm or abnormal sperm.
There is a small modification of this method called PICSI. To understand this, it is necessary to delve into some of the fundamentals of reproductive biology: in order to fertilize an oocyte, only a small part of the sperm must enter the cytoplasm, namely the contents of the sperm head. During normal fertilization, before the sperm reaches the oocyte by the oocyte, a process called “capacitation” begins, the main result of which is the softening of the sperm head membrane and successful penetration through the oocyte membranes. The capacitation process is triggered by the contact of the sperm with certain chemicals, one of which is called “hyaluronic acid”. Due to some genetic or acquired problems, sperm cells lose the ability to initiate capacitation and cannot successfully fertilize oocytes. To overcome this, your clinical embryologist will use PICSI: this method is very similar to conventional ICSI, but a sperm drop is applied to hyaluronic acid that has been pre-added to special laboratory dishes. Sperm, which are able to bind to hyaluronic acid, move in place, then they can be collected by the embryologist for fertilization of oocytes by “injection” into the egg. This helps to solve some of the problems of male infertility and to help couples get a long-awaited and healthy child in their family.
Your fertility specialist at the Lada clinic, together with a clinical embryologist, will help you choose the right method of infertility treatment in accordance with your medical history.