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How to choose the worthiest one?

The efficacy of IVF programmes depends on a large number of different factors: the proper complete medical examination of a couple, a patient’s readiness for stimulation, the choice of a protocol, the ovarian response, the quality of the endometrium et cetera. One of the most important conditions for a successful infertility treatment is the meticulous and well-organized work of an embryologist. Today, Embryology has at its disposal a multitude of modern methods for oocyte selection, immature oocyte maturation, egg cell fertilization, sperm cell selection, embryo cultivation as well as different methods for the сryoconservation of biological tissues.

One of the interesting methods for sperm cell selection in an IVF programme is HBA – a sperm cell-hyaluronic acid binding test (PICSI).

Hyaluronic acid is the major component of the cumulus complex surrounding an egg cell. Mature sperm cells with a high degree of DNA integrity and a normal aneuploidy level are capable of binding to hyaluronic acid with the help of specific receptors located on their heads. In contrast, immature sperm cells are incapable of binding to hyaluronate. In ICSI, sperm cells are selected based on the visual assessment of their morphology and motility, but this approach is not always effective. In clinically apparent forms of pathospermia when there are but individual normal sperm cells in the ejaculate, it is very important to try to select material for fertilization with a maximally mature genetic material. PICSI makes it possible to perform a quick assessment of the degree of maturity and structural integrity of sperm cells as well as to evaluate the correlation between the morphology and the fertilizing ability of sperm cells and thus to overcome the influence of a male factor on the quality of an embryo. In this test, the number of sperm cells that have managed to bind to hyaluronic acid is counted. If the proportion of such sperm cells in the ejaculate is higher than 80%, we can make do with ICSI in an IVF programme, without harming embryos in any way. If the percent of such sperm cells is lower, PICSI is preferred for choosing the leading sperm cell that will be given the right to fertilize an egg cell.