Picsi® dish for sperm selection

The PICSI® dish with Hyaluronan microdots for easy sperm selection

The PICSI® dish is a dish for intracytoplasmic sperm injection (ICSI) with hyaluronan microdots, supporting the selection of mature spermatozoa with better DNA quality.^1,2

• Supports the selection of mature spermatozoa with increased chromatin integrity, better DNA packaging, and reduced risk of aneuploidy.^1-4
• Simple implementation into clinical practice.
• Easy and convenient to use.⁵
• Hyaluronan-based selection of spermatozoa for ICSI could be considered as part of the treatment plan for advanced age couples and patients with previous unsuccessful ICSI attempts.^2,6

Clinical benefits of sperm selection with PICSI® dish:

• Significantly decreases miscarriage rates.^7,8
• Improves live birth outcomes among older couples and helps to mitigate the poor prognosis usually ascribed to advanced maternal age.²
• May provide better treatment outcomes after previous failed ICSI cycles.⁶

Availability

This product is available for sale in Europe, the U.S.A as well as selected countries in the rest of the world.

Mimicking the natural sperm selection mechanism

Hyaluronic acid (HA) or hyaluronan is a naturally occurring organic polymer that is also a major component of the extracellular matrix of the oocyte-cumulus complex. During the natural fertilization process human oocytes are surrounded by hyaluronan, which is acting as a ‘‘physiologic selector’’ of spermatozoa.⁵

Only fully mature spermatozoa can bind to hyaluronan, as hyaluronan receptors appear on the plasma membrane during late spermiogenesis after the maturation-related plasma membrane remodeling. This is accompanied by the loss of the residual body via cytoplasmic extrusion, DNA repackaging from histones to protamines and zona pellucida-binding site formation.⁵ It was demonstrated that the ability of spermatozoa to bind to hyaluronan is correlated with sperm maturity, increased chromatin integrity, decreased chances of aneuploidy, lower sperm DNA fragmentation and better sperm DNA packaging⁴.

Indeed, immature spermatozoa that fail to undergo membrane remodeling have no receptors to hyaluronan and the zona-pellucida. They also demonstrate presence of residual cytoplasm, persistent histones, and increased risk of chromosomal aneuploidies and DNA fragmentation.^3,4 Immature spermatozoa are unable to bind to hyaluronan and the zona pellucida and therefore would be excluded from the natural fertilization process.

During standard ICSI, all natural selection mechanisms are bypassed, and spermatozoa are selected based on their morphology and motility only.

Selection of sperm, capable to bind to hyaluronan for ICSI mimics the natural sperm selection process and is therefore often called “physiologic ICSI.” It was demonstrated, that “physiologic ICSI” using a PICSI® dish can reduce miscarriage rates,^7,8 improve treatment outcomes among older couples,² and patients with a low percentage of mature spermatozoa⁸ and after a failed ICSI attempt.⁶

The PICSI® dish is a polystyrene dish for ICSI with three microdots of hyaluronan attached to the interior bottom surface. There are three arrows pointing to the dots to facilitate their location.

Hydrate the microdots by covering them with ≈10μL drops of appropriate media.

Other drops, like PVP and drops for oocytes, can be added to the dish the way you prefer (the picture shows just an example of drop layout). Immediately cover the PISCI® dish with the appropriate amount of oil.

Add prepared spermatozoa to the edge of the hydrating media covering the hyaluronan microdots under oil. Motile sperm start swimming to the hyaluronan dot, and mature ones will bind to it.

Hyaluronan-bound sperm (green on the drawing) are easily identified: they exhibit no progressive migration despite vigorous tail beating. They can be easily picked up and transferred to PVP drop for immobilization.

Key publications that are supporting the clinical efficiency of sperm selection with the PICSI® dish
– improving your patient’s chances

By using the PICSI® dish, embryologists ensure that spermatozoa injected into oocytes have better chances to be mature and contain non-damaged DNA.⁵

Sperm selection with a PICSI® dish significantly decreases miscarriage rate compared to standard ICSI.⁷

In 2019, the so-called HABSelect study was published – a randomized controlled trial (RCT), that was carried out in 16 IVF centers across the UK, it included 2,752 couples and was supported by the UK National Institute for Health and Care Research. The study compared clinical outcomes of sperm selection using a PICSI® dish with conventional ICSI.

It was shown that the use of a PICSI® dish led to a significant decrease in the miscarriage rate compared to conventional ICSI, as shown below.

By using the PICSI® dish, embryologists ensure that spermatozoa injected into oocytes have better chances to be mature and contain non-damaged DNA.⁵

Parallel, two-group, double-blinded RCT, carried out in 16 IVF clinics in the UK on 2,752 couples undergoing ICSI or PICSI

Sperm selection with HA improves live birth outcomes among older couples and is connected to sperm DNA quality, potentially affecting all treatment outcomes.²

Results of the mechanistic part of the HABSelect study, published in 2022, demonstrated that the Hyaluronan-binding score correlated with sperm DNA quality, showing that sperm capable of binding to hyaluronan are more likely to have compact chromatin and intact DNA.

The authors also built a predictive model from aggregation of the original HABSelect trial data into 10-year intervals for male and female age. It was shown that older men and women randomized to the sperm selection using PICSI® dish group  had the same live birth rates and same low miscarriage rates as younger patients, most likely due to avoidance of sperm with damaged DNA.

The modeled live birth and miscarriage data strongly suggest that sperm selection using a PICSI® dish particularly mitigates the poor prognosis usually ascribed to women of advanced maternal age.

Modeled, predicted live birth rate and miscarriage rate with female age following ICSI or physiologic ICSI using PICSI® Dish

HA sperm selection significantly improves the clinical outcome of couples with previous ICSI cycle failure⁶

A retrospective study of 167 couples with one failed ICSI attempt with low fertilization rates and poor embryos showed that cleavage rate, embryo quality, pregnancy and implantation rates were significantly higher in the group undergoing physiological ICSI with the PICSI® dish compared to conventional ICSI. The use of hyaluronan for sperm selection may provide better treatment outcomes after a previous failed ICSI cycles.

Clinical pregnancy and implantation rates with standard ICSI or physiological ICSI using PICSI® Dish following one previous failed ICSI
attempt characterized by low fertilization rate and poor embryo quality

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