FERTILITY & REPRODUCTIVE MEDICINE Procedure

Micromanipulator ICSI / PICSI Single Sperm Injection

Micromanipulator-guided single sperm selection (IMSI / PICSI) and direct intracytoplasmic microinjection into mature Metaphase II (MII) oocyte cytoplasm, overcoming severe male factor subfertility.

ICSI — intracytoplasmic sperm injection

Clinical Overview & Disease Information

Micromanipulator-guided single sperm selection (IMSI / PICSI) and direct intracytoplasmic microinjection into mature Metaphase II (MII) oocyte cytoplasm, overcoming severe male factor subfertility.

Signs & Symptoms

Early Symptoms

• Severe male factor subfertility (low sperm count, zero motility, abnormal sperm morphology)
• Repeated fertilization failure in standard IVF cycles

Common Symptoms

• Obstructive or non-obstructive azoospermia requiring surgically retrieved sperm (TESA/Micro-TESE)
• High sperm DNA fragmentation index (DFI > 30%)

Emergency Symptoms

• Acute testicular pain or scrotal hematoma post-TESA biopsy

Causes & Risk Factors

Primary Causes & Etiology

Severe Oligoasthenoteratozoospermia (OATS)
Y-chromosome microdeletions or genetic testicular failure
Prior vasectomy or congenital absence of vas deferens (CBAVD)

Who is at Higher Risk?

Couples with severe male factor subfertility or prior IVF fertilization failure

Diagnostic Evaluation & Testing

Diagnostic Test	Clinical Purpose / What It Shows
Computer-Assisted Semen Analysis (CASA WHO 2021 Criteria)	Measures exact sperm concentration, progressive motility, and strict Kruger morphology
Sperm Chromatin Structure Assay (Sperm DFI Index)	Quantifies sperm DNA strand break fragmentation

Comprehensive Treatment Options

Micromanipulator Physiological ICSI (PICSI / IMSI) Injection

Selection of mature hyaluronic acid-bound sperm under 6600x optical magnification and microinjection into MII oocytes using inverted Nikon microscope.

Key Advantages:

Overcomes 99% of severe male factor infertility barriers

Achieves high fertilization rates (> 75-80%) per oocyte injected

Enables biological fatherhood even with single retrieved sperm

Micro-TESE / TESA Sperm Retrieval with ICSI

Microsurgical testicular sperm extraction combined with immediate ICSI.

Recommended For:

Men with non-obstructive azoospermia (NOA)

Advanced Medical Technologies Available in Partner Hospitals

Inverted Micromanipulator Microscope Hyaluronan-Binding PICSI Dish Laser-Assisted Hatching

Possible Complications If Untreated

Oocyte mechanical damage during injection (< 2%)

Variable fertilization in cryptozoospermia

Recovery Timeline, Diet & Lifestyle Care

Recovery Timeline

Procedure / Stage	Expected Recovery Duration
Egg Retrieval & ICSI Microinjection	Day 0
Fertilization Check & Blastocyst Culture	Day 1 to 5
Embryo Transfer & Luteal Support	Day 5

Essential Lifestyle Changes

Avoid smoking, alcohol, and hot baths for men prior to sperm collection
Follow daily progesterone schedule post-transfer

When to Contact a Doctor Urgently:

Heavy vaginal bleeding

Severe pelvic pain

High fever

Prevention & Long-Term Health

Early semen analysis screening and varicocele treatment

Frequently Asked Questions

What is the difference between IVF and ICSI?

In standard IVF, thousands of sperm are incubated around an egg to fertilize naturally. In ICSI, a single selected healthy sperm is directly injected into the egg.