Infertility is a common worldwide issue among couples. There are various causative factors for fertility issues. One such common male factor for infertility is poor or abnormal sperm morphology.

A couple with a male partner having poor sperm quality is not able to let his female partner carry a healthy pregnancy and become a father of his child. For couples going for IVF, its success depends upon the selection of healthy, mature, non-apoptotic sperm as the sperm quality directly influences the embryonic development and chances of successful pregnancy. Luckily, there are ways such as PICSI, MACS, MICROFLUIDICS for functional sperm selection by which such infertile men can still make their partner’s pregnancy a success.

At Sree Nandaka Fertility & Laparoscopy Hospital, we have the best specialists who are well-versed and highly experienced doctors who are experts in performing PICSI, MACS and MICROFLUIDICS procedures in Hyderabad at the best possible price.

PICSI Procedure in Detail

PICSI involves several steps:

• Preparation of Hyaluronan-Coated Dish: A dish is coated with a substance called hyaluronan, which is a component found in the cumulus cells surrounding the egg. This substance mimics the natural environment of the egg and helps in selecting mature and healthy sperm. In modern practice, ready to use pICSI dishes are used commonly.
• Semen Sample Collection: A semen sample is collected from the male partner. This sample undergoes processing to separate sperm from seminal fluid and other debris.
• Sperm Selection: The processed sperm sample is placed onto the hyaluronan-coated dish. Mature and healthy sperm have specific receptors that bind to hyaluronan. These sperm will adhere to the dish while immature or unhealthy sperm will not.
• Identification of Bound Sperm: Under a microscope, the bound sperm, which have attached to the hyaluronan, are identified. These sperm are considered to have better quality and are more likely to fertilize an egg successfully.
• Sperm Injection: The selected sperm are then individually picked up using a needle and injected directly into the egg cytoplasm using a technique called intracytoplasmic sperm injection (ICSI). This improves fertilization even in cases where sperm quality or quantity is low.

MACS Procedure in Detail

MACs technique is a simple, non-invasive, technique that will efficiently reduce DNA fragmentation in infertile patients prior to ART.

Magnetic Activated Cell Sorting is a procedure that isolates the healthy sperms from the unhealthy sperms. The semen is passed through a magnetic field in a separating column. The dead and apoptotic sperms are retained within the separation columns whereas the good quality live sperms get collected separately. MACS are helped to attain better pregnancy rates and reduce implantation failures therefore it is mainly employed in cases of poor implantation rate, repeated IVF failures, and high DNA fragmentation in sperms. Once the sperms are separated the eggs are fertilized by ICSI (Intracytoplasmic sperm Injection) which is a micromanipulation technique employed in IVF treatment where the healthy sperm is injected into the cytoplasm of the egg using a fine needle. ICSI does not depend upon the ability of the sperm to move on its own and attach itself to the egg. The cellular process of fertilization occurs inside the egg which has got to happen naturally. MACS is indicated in patients with a higher index of DFI (DNA Fragmentation Index) greater than 25% which indicates poor DNA integrity. IVF/ICSI techniques are performed once the sperms are separated using MACS.

MICROFLUIDICS Procedure in Detail

Microfluidic Sperm Sorter is an integrated and advanced technique that helps promote the motile sperms to swim up in the microchannel leaving behind immotile or less motile one. It is used for spermatozoon selection with less fragmented DNA as compared to the usual technique used for selection of spermatozoa in the sample. It is a unique and an upgraded process for selection of highly motile sperms which is an important criteria for ICSI or PICSI to attain successful pregnancy.

Procedure: It is an exceptional way of selecting spermatozoon as in this we can use the raw liquefied semen sample directly without the need for centrifugal separation. Excess centrifugation of raw samples generally tends to release of Reactive oxygen species (ROS) which further causes DNA fragmentation. Therefore by using a microfluidic sperm sorter we reduce the risk of induced DNA fragmentation. There are 2 ports device inlet port and otlet port where 850µL liquified semen sample is added into to the device inlet port and 850µL of incubated media is injected through the outlet port. Completely cover the upper membrane with the media. Cover the device with the petri dish and incubate at 37ºC for 30 min. The sperm suspension added in inlet port and media in outlet port so that it can flow in a parallel direction through the microporous filter in between them. Sperm with high motility and normal morphology and less DNA Fragmentation swim through the membrane and reaches the upper membrane those with poor morphology and less motility float under the membrane.