PICSI (physiological intracytoplasmic sperm injection)

What PICSI involves

The UK fertility regulator, the HFEA, describes PICSI as “a technique used to select sperm to use in Intracytoplasmic sperm injection (ICSI) treatment. It involves placing sperm with hyaluronic acid (HA), a natural compound found in the body. PICSI identifies sperm that can bind to HA and these sperm are selected for use in treatment.”

So PICSI does not replace ICSI; it changes how the sperm is chosen. The injection, and the rest of the IVF cycle, are unchanged.

An add-on, not a treatment on its own

The HFEA lists PICSI among treatment add-ons, “optional non-essential treatments or tests that may be offered in addition to such proven fertility treatment”, and describes it as “in use for patients having ICSI treatment for male factor infertility”. It publishes its own rating of the evidence for PICSI, and this directory links to it rather than restating it.

Its general note on add-ons: “For most patients, having a routine cycle of proven fertility treatment is effective without using any treatment add-ons.” Whether it is appropriate in a particular case is a clinical decision for the treating doctor. This directory does not make that judgement.

What the regulator says about risks

The HFEA states: “PICSI is a non-invasive test performed on a semen sample as an additional step in the ICSI process. The risks associated with the use of ICSI also apply to PICSI.” Those ICSI risks are quoted in full on the ICSI page.

A different selection method, using very high magnification, is covered on the IMSI page. Clinics in this directory that name ICSI itself: 321.

Questions

What does PICSI select for?

The HFEA says “PICSI identifies sperm that can bind to HA and these sperm are selected for use in treatment.”

Does PICSI add risk?

The HFEA says “The risks associated with the use of ICSI also apply to PICSI.”

Is PICSI charged separately?

This directory holds no prices. Add-ons are often priced separately; ask each clinic for an itemised quote.

Sources

• HFEA, Physiological intracytoplasmic sperm injection (PICSI), read 25 September 2026.
• HFEA, Treatment add-ons, read 25 September 2026.
• HFEA, Pre-implantation genetic testing for aneuploidy (PGT-A), read 25 September 2026.
• The Assisted Reproductive Technology (Regulation) Rules, 2022, G.S.R. 419(E), 7 June 2022, para 10.1 (not changed by the Amendment Rules, 2026, G.S.R. 491(E)), read 25 September 2026.
• Clinic data: each clinic's own website, as read by this directory; registry level from the National ART & Surrogacy Registry extract.