Matrushri
Fertility Centers Consultancy (Agencies)
Physiological Intracytoplasmic Sperm Injection
PICSI selects only the most mature, genetically healthy sperm using hyaluronan — the same natural molecule eggs use — delivering superior fertilisation, fewer miscarriages, and better embryo quality than standard ICSI.
PICSI — Physiological Intracytoplasmic Sperm Injection — is an advanced form of ICSI that adds a crucial biological layer to sperm selection before injection into an egg. While standard ICSI selects sperm based on visual appearance (morphology) under a microscope, PICSI goes deeper by testing each sperm's ability to bind to hyaluronan — a naturally occurring substance found in the outer layer of human eggs.
💡 The Key Insight: In natural conception, only sperm that can bind to hyaluronan can penetrate the egg. This binding ability is a marker of sperm maturity, intact acrosome, and — critically — low DNA fragmentation. PICSI mimics this natural filter in the laboratory.
Sperm that bind to hyaluronan are more likely to have normal chromosomal content and lower levels of DNA damage, leading to better fertilisation, higher-quality embryos, lower miscarriage rates, and ultimately, healthier babies.
At Matrushri, PICSI is offered as an upgrade to ICSI cycles for couples where sperm quality or previous IVF failures suggest it would be beneficial.
PICSI adds one powerful biological step to the standard ICSI process — hyaluronan-binding sperm selection — performed entirely in our Class 1000 IVF laboratory.
The male partner provides a semen sample, which is processed and washed to separate healthy sperm from seminal fluid, debris, and immotile sperm.
Day of Egg RetrievalThe prepared sperm are placed onto a special PICSI dish coated with hyaluronan hydrogel — the same substance present on the surface of human eggs in the body.
Laboratory StepOnly mature, chromosomally normal sperm with intact acrosomes bind to the hyaluronan. Immature or DNA-damaged sperm cannot bind and are excluded.
Biological FilterOur expert embryologist identifies and selects the best sperm from those that have bound to the hyaluronan, using high-magnification microscopy for final selection.
Expert SkillThe selected sperm is injected directly into the mature egg (oocyte) using a fine glass needle — the same process as standard ICSI, but with a superior sperm.
MicroinjectionFertilised eggs develop into embryos in our Class 1000 incubators for 3–5 days. The best embryo(s) are selected for transfer or cryopreservation.
Class 1000 LabUnderstand exactly how PICSI improves upon standard ICSI — and when it makes the most difference.
PICSI is particularly beneficial in specific clinical situations where standard ICSI may not deliver optimal outcomes.
Men with elevated DNA fragmentation index (DFI >25%) on sperm DNA fragmentation testing — PICSI reduces the chances of selecting a damaged sperm for injection.
Couples who have had two or more failed IVF or ICSI cycles with good embryo quality — upgrading to PICSI may address an undetected sperm factor.
Couples with repeated pregnancy loss — especially where chromosomal causes of miscarriage have been excluded — often benefit from PICSI's superior sperm selection.
Where previous IVF cycles produced embryos that arrested early or were of consistently poor quality despite good eggs — sperm DNA may be the contributing factor.
Men with very low sperm counts (severe oligospermia), poor morphology, or retrieved sperm from TESA/Micro-TESE — PICSI maximises the quality of the selected sperm.
Older women have fewer eggs to work with — PICSI helps maximise the chances of each egg being fertilised by the best possible sperm, protecting every precious oocyte.
Hyaluronan (HA) is a naturally occurring polysaccharide found abundantly in the cumulus oophorus — the layer of cells surrounding the mature egg. In the fallopian tube, only sperm with a specific surface receptor (CD44) can bind to hyaluronan, allowing them to penetrate the cumulus and reach the egg.
Research has shown that HA-binding sperm have consistently superior characteristics compared to randomly selected sperm of similar morphology:
The landmark HYPER trial (published in NEJM Evidence, 2021) demonstrated that PICSI significantly reduced miscarriage rates compared to standard ICSI in a large randomised controlled trial.
From your first consultation to embryo transfer — here is exactly what to expect at Matrushri.
Meet your fertility specialist. Your medical history, previous investigations, and prior IVF outcomes are reviewed. A decision is made whether PICSI is indicated for your case, and a tailored treatment plan is discussed.
Day 1Semen analysis, sperm DNA fragmentation test, hormonal profiling for both partners, pelvic ultrasound (antral follicle count, AMH), and any other required investigations are completed.
Week 1–2The female partner begins daily hormone injections to stimulate the ovaries to produce multiple mature eggs. Close monitoring with regular ultrasounds and blood tests ensures a safe, optimised response.
10–14 DaysWhen follicles are mature, a trigger injection is given. 36 hours later, eggs are retrieved under sedation via transvaginal ultrasound-guided aspiration — a short, minimally painful procedure.
Day of RetrievalThe semen sample is prepared and placed onto the hyaluronan-coated PICSI dish. Our embryologist identifies the best bound sperm under high magnification. Only the finest, biologically selected sperm proceed to injection.
Same Day — Lab StepThe selected sperm is injected directly into each mature egg using a fine glass pipette under a high-powered microscope. Fertilisation results are assessed 16–18 hours later.
Same DayFertilised eggs (zygotes) develop in our Class 1000 incubators for 3–5 days. Daily monitoring tracks embryo quality and development stage — from 2-cell to blastocyst.
Day 3–5The best quality embryo(s) are transferred to the uterus in a simple, painless procedure. Remaining good-quality embryos are vitrified (frozen) for future use. Pregnancy test is performed 14 days later.
Day 3 or Day 5PICSI requires expert embryologists, specialised equipment, and a certified laboratory. Matrushri delivers all three.
Our internationally certified clean-room laboratory maintains the optimal environment for all stages of PICSI — from sperm binding to embryo culture and vitrification.
PICSI demands precision and skill. Our senior embryologists are trained in hyaluronan-binding sperm selection and perform every procedure with exacting care.
We perform in-house sperm DNA fragmentation analysis to identify which patients will benefit most from PICSI — ensuring it is offered to the right couples.
PICSI is never a routine add-on. It is recommended based on your specific test results and history — always as part of a fully individualised treatment plan.
We explain the cost, expected benefit, and evidence base for PICSI in advance. No hidden charges — and you decide whether to proceed with full information.
Consultations are available at all 11 Matrushri centres. PICSI procedures are performed at our specialist IVF units equipped with the required laboratory infrastructure.
Speak with our fertility specialists to find out if PICSI could improve your IVF outcomes. Book a free, confidential consultation today.
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