The purpose of ICSI is to assist the fertilization process when a man’s sperm count is abnormal. Whether it is because the number of motile sperm is very low or the morphology is excessively poor, the technique involves the delivery of a single sperm into a single egg. Since 1991, when it was first described, it has revolutionized the treatment of male infertility. Most clinics started out recommending ICSI if there is a fear that poor fertilization may occur by traditional IVF where sperm are merely added to the egg culture dish.   Currently with most IVF, ICSI is utilized to obtain the highest likelihood of fertilization, and to reduce the risk of polyspermia, (more than one sperm fertilizing the egg).  Accordingly, efforts are made to assess sperm by function or morphology to help determine those most likely to require ICSI, and at IVF Phoenix, we use a more physiological approach to selecting sperm for ICSI called PICSI. This involves having sperm bind to hyaluronic acid, then selecting those sperm for ICSI.  The egg shell is made of hyaluronic acid, and it is show that sperm which bind to HA, have higher intact DNA and less DNA fragmentation.   It is best to discuss this option with Dr Couvaras and our Embryologist prior to treatment.