Monday, 5 October 2015

Is the future of Intra- Cytoplasmic Sperm Injection (ICSI) - PIEZO ICSI ?



When I attended the ACE 2015  conference, I was privileged to listen to an  interesting lecture by a Japanese embryologist. It was concerning a new technology called PIEZO  ICSI, wherein  vibration was used to puncture the egg instead of a needle, as employed in conventional  ICSI procedure. 

First let us understand the conventional ICSI procedure. ICSI is a process in which a sperm is directly injected into an egg. In current micromanipulators, sharp needle is used to forcibly penetrate the egg  through the zona pellucida (protecting cover of egg ) which causes considerable deformation of the zona or in simple terms creates a hole. This deformation may increase the internal pressure of the oocyte, (egg) induce the emission of ooplasm (cytoplasm inside the egg) from the oocyte after removal of the needle and may cause oocyte death.

Since the cytoplasm inside cell (egg)  has high extendibility, the inserted needle may not penetrate the cytoplasm. So the sperm should be injected after aspiration of the matter into the pippette, which is done by the embryologists. They aspirate little cytoplasm  and then only inject the sperm into the egg cell.

The first report on piezo-ICSI was published by Kimura and Yanagimachi (1995), who used mice as subjects. By means of this method, egg penetration can be achieved by voltage of piezoelectric elements. Similarly, after the cytoplasm is reached it can be punctured by applying one piezo pulse. 

So basically vibration is used to puncture the egg, there is no sharp needle, but only a smaller blunt needle. Therefore, chances of injuring the egg is less. Moreover, there is no need to aspirate the matter from egg contents to confirm entry, which again reduces the chances of harming the egg.

Currently, this method is being used in Japanese fertility centers, with higher success rate than conventional ICSI.  It is quiet expensive to maintain an ART lab, so upgrading with new equipment can be a challenge in the current Indian scenario, as ultimately the patients will have to  bear the brunt.




Reference

Dr. Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre

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Dr. Anita Mani is a renowned infertility specialist in south India with 15 years experience in ART (Assisted Reproductive Technology). Dr. Anita has successfully set up ART hospitals in Cochin and Bangalore,  along with her spouse  Dr. S Mani, who specialises in surrogacy. She completed MRCOG, from Royal College of Obstetrician and Gynaecologist  London, DFFP from  ART Warwick university and  worked in UK for 5 years. Dr. Anitha believes in scientific and ethical practice and is currently the director of Gift Gyno IVF centre Cochin and  Bangalore.  Apart from advanced laparoscopic surgeries, she is also an expert in various ART techniques including IVF, IUI, ICSI , donor egg / sperm  and surrogacy . Her proficiency is in genetic abnormalities and high risk pregnancies.


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