#258 : Evaluating the Clinical Utility of Physiological ICSI

Abstract

Background and Aims: Physiologic ICSI (PICSI) is a method of ICSI in which sperm attached to hyaluronic acid (HA) are selected. It is known that mature sperm express receptors for adhesion to the HA due to reconstruction of the protoplasmic membrane. In fact, it has been confirmed that sperm that can adhere to HA are mature sperm, and it has been reported that their DNA is highly normal. However, previous studies on the clinical outcomes of PICSI have shown inconsistent results. Therefore, the purpose of this study was to evaluate the clinical usefulness of PICSI using sibling oocytes. Method: The 365 cycles in which two or more mature oocytes were obtained in ICSI cycles were included, and the sibling oocytes of the same cycle were equally divided between conventional ICSI and PICSI methods. Sperm selection was based on sperm morphology and motility in the conventional method, while adhesion to HA was taken into account in the PICSI method. The evaluation items were embryonic developmental potential and clinical pregnancy and miscarriage rates after single frozen thawed blastocyst transfer. Results: The normal fertilization rates for the conventional and PICSI methods were 81.3% and 80.8%, respectively; the blastocyst rates were 64.7% and 68.2%, respectively; and the good blastocyst rates were 30.8% and 31.8%, respectively. There were no significant differences in any of the endpoints (Table 1). There were no significant differences between the two groups in clinical pregnancy and miscarriage rates after single frozen thawed blastocyst transfer (Table 2). Conclusion: In the patients in this study, the clinical outcomes of PICSI were equivalent to those of the conventional method, and the clinical benefit of PICSI was not demonstrated. In the future, it will be necessary to examine the conditions under which PICSI is effective.