Fertility Decoded

PICSI (physiological ICSI)

Selecting sperm by their ability to bind hyaluronan before injecting them into the egg.

Written by Fertility Decoded. Reviewed by D R, MS (OBG), FRM. Review date: 31 August 2026.

The verdict

No effect on your chance of a baby.

Who are these bodies?

HFEA
— UK fertility regulator; rates add-ons by evidence (traffic-light).
ESHRE
— European fertility society; evidence-based practice guidance.
NICE
— UK health-guidance body; what the NHS will and won't fund.
ISAR
— Indian Society for Assisted Reproduction; Indian expert consensus.
Cochrane
— Independent global reviewers of the underlying studies.

  • HFEA

    UK regulator

    Black — no effect — chance of a baby
    Source

  • ESHRE

    European society

    Not for routine use

    Not recommended for routine clinical use.

    Source

  • NICE

    UK NHS guidance

    Not addressed

    Not addressed in NG257.

  • ISAR

    Indian society

    Needs robust RCTs

    Need robust RCTs to recommend use (cites Cochrane 2018 low-quality; Miller/Lancet 2019: no effect on live birth, HA-ICSI may lower miscarriage).

    Source

  • Cochrane

    Evidence base

    Large RCT (HABSelect) found no improvement in live birth.

Typical cost in India

Charged as an advanced-lab add-on, ~₹10,000–25,000 (varies; often bundled).

Sources

Take this further

Sources last reviewed .