If you desperately want to have a child, you don’t have to remain childless against your will. Thanks to Physiological Intracytoplasmic Sperm Injection (PICSI), you can still fulfill your dream of having a baby if it doesn’t work out naturally.
Here you’ll find all the information and specialists you need.
Even when couples decide to have a baby, it’s not always easy to get pregnant. Sometimes stress or hormonal fluctuations are partly to blame for why it doesn’t work out.
If physical issues are the cause, artificial insemination may be a viable option.
PICSI (Physiological Intracytoplasmic Sperm Injection) is a modern procedure for selecting sperm that have reached a specific stage of maturity. Doctors screen out sperm with an abnormal number of chromosomes. The goal is to minimize the miscarriage rate.
Artificial insemination with PICSI: How does this method work?
If the desire to have a child remains unfulfilled, it may be due to the quality of the sperm. The shape and motility of the sperm are just as important in the selection process as their stage of maturity.
Physiological Intracytoplasmic Sperm Injection is an extension of Intracytoplasmic Sperm Injection (ICSI). In ICSI, doctors inject the sperm directly into the eggs.
In contrast to the ICSI procedure, doctors use special hyaluronan-coated trays during PICSI, to which only mature sperm can bind. The reason: Only mature sperm have a hyaluronan receptor on the head of the sperm.
It is also helpful that hyaluronan is a major component of the membrane surrounding the egg (zona pellucida). Therefore, even in the natural process, only mature sperm can bind to the hyaluronan in the egg’s outer layer. They then eventually penetrate the egg.
Artificial insemination under a microscope @ DAntes /AdobeStock
How does artificial insemination work?
There are several methods of artificial insemination. The different procedures vary in how and where sperm and eggs meet:
- In a “test tube” or
- Inside the human body
In artificial insemination performed outside the body, natural fertilization of the egg by the sperm can take place in a dish.
It is also possible for doctors to inject the sperm directly into the cytoplasm of the egg using micromanipulation.
In insemination, on the other hand, doctors place the prepared sperm into the woman’s uterus. The sperm and egg fuse naturally in the woman’s fallopian tube.
Many couples have surplus fertilized eggs frozen (cryopreservation). A reserve, so to speak, in case pregnancy does not occur the first time or if they wish to have more children.
The hormone therapy used in artificial insemination allows multiple follicles to mature in a single cycle and enables controlled ovulation.
Promising medications include:
- Follicle-stimulating hormone (FSH)
- Human menopausal gonadotropin (HMG)
Public health insurance plans usually cover part of the costs, although couples typically have to pay 100 percent of the cost of the preliminary examinations.
Statutory health insurance plans subsidize each procedure, though couples must pay a copayment. The total cost depends on the treatment and the number of artificial inseminations.
PICSI, ICSI, & IMSI: What’s the Difference?
When sperm quality and/or sperm concentration are compromised, doctors use the ICSI procedure. In this procedure, they inject a single sperm directly into the egg using micromanipulation.
IMSI (intracytoplasmic morphologically selected sperm injection) is an extension of ICSI in which experts examine the sperm beforehand. Using high magnification, they can select normally shaped sperm without vacuoles (fluid-filled cavities) for injection.
PICSI (Physiological Intracytoplasmic Sperm Injection) is an extension of ICSI. Here, experts can specifically select mature sperm. This eliminates the risk of using sperm with an abnormal number of chromosomes.
Cryopreservation: If it doesn’t work the first time
Since pregnancy does not always occur on the first attempt at artificial insemination—or if a couple wishes to have another child—it is possible to have surplus fertilized eggs frozen. This way, you can avoid another round of ovarian stimulation and egg retrieval (follicular puncture). This method is called cryopreservation.
Cryopreservation allows women to store their eggs for later use @ sola_sola /AdobeStock
It’s not only suitable for couples hoping to have children, but also for young women who want to preserve their eggs for later. In this case, it’s referred to as “social freezing.”
Cryopreservation is also suitable for men who are about to undergo treatment that damages germ cells (chemotherapy). They can build up a “reserve” as a precaution in case they decide to undergo sterilization.
