PICSI is a similar approach to achieve IVF in Nepal. PICSI is a updated version of ICSI. In ICSI process, injectable sperm is selected on the basis of their structure (morphology), which may not be the effecient functionally i.e. a normal looking sperm may not be fertile. In simple ICSI, the sperm is choosen by its morphology and motality, irrespective of functionality. The PICSI process uses PICSI dish that can test the functionality of the sperm. The test is based on the ability of sperm to bind to hyaluronan(HA) hydrogel, if it bind with the HA hydrogel, it will also bind with the oocyte. Hyaluronan is a naturally occurring biopolymer found in all human cells. The sperm that bind with the HA is more matured and is of better quality.
A special dish, PICSI dish is used with small dot of HA on the bottom of the dish along with the standard ICSI injection. Prepared sperm is added to HA and sperm that bound with HA is selected for fertilization. Less or no DNA damage is found in sperm bound to HA.