The advances of assisted reproduction

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Intracytoplasmic Sperm Injection (ICSI) represented the greatest progress in terms of assisted reproduction techniques after In Vitro Fertilization (IVF) and Artificial Insemination (AI). It is a more elaborate technique since it manually introduces the sperm inside the ovule with the help of a microneedle.

Below you have an index with all the points that we will discuss in this article.

Index

The advances of assisted reproduction

To improve the ICSI technique, other techniques have been developed that allow the selection of the most appropriate sperm, thus increasing the probability of fertilization and pregnancy rate. Next we are going to comment some of these methods.

PICSI

The physiological ICSI method, also known as PICSI by English name, is a simple technique that allows you to pre-select the sperm that will be used in an ICSI thanks to its attraction to hyaluronic acid, a polysaccharide found in the zona pellucida. that surrounds the ovule and participates in the recognition of the sperm, facilitating fertilization.

Mature male gametes that do not have fragmentation in their DNA will be able to adhere to the synthetic zona pellucida. They will remain glued to the plate and will be selected, carefully recovered and used for injection into the cytoplasm of the ovule (ICSI).

MACS

The technique of Annexin Columns, also known as MACS (Magnetic Activated Cell Sorting) allows the selection of sperm with the whole DNA thanks to an immunomagnetic selection. It allows to separate healthy sperm from dead sperm or with fragmented DNA.

Defective sperm remain attached to the column because Annexin V has a strong attraction for phosphatidylserine, a phospholipid on the inner side of the membrane. If the sperm is defective and has accessible phosphatidylserine, it is bound to Annexin V of the column. Healthy sperm cross the column and are used for the ICSI technique.

Columns of Annexin V

In addition to these sperm selection techniques, there are others that also improve the pregnancy rate.

IMSI

So far, the analysis and selection of ejaculate or testicular sperm for the ICSI technique was somewhat subjective. It was based on the vision of the head, tail and the intermediate segment of the gametes, which were chosen by the specialist.

The Intracytoplasmic Microinjection of Morphologically Selected Sperm, IMSI, is a technique by which a powerful microscope is used to visualize sperm at 6,300 magnifications. The visualization of the morphology is very detailed, at high magnification and without stains that damage the sperm. This allows to safely discard all those gametes that have a defective morphology and that could cause problems in fertilization.

This technique is also called super ICSI.

Embryoscope

It is a non-invasive technique. It is an embryo incubator that allows the embryo to be observed from second to second, from the moment of In Vitro Fertilization to the transfer to the uterus.

It takes images of the embryo automatically every 15 minutes and presents a great advantage since it is not necessary to extract the embryo to observe its quality and development so that the sample is not destabilized during the entire culture time.

Embryo incubator

The future of assisted reproduction

Work is underway to improve Preimplantation Genetic Diagnosis (PGD) techniques since they present the problem that, during some studies, embryos are damaged. It also allows the selection of healthy embryos but does not allow treating diseases in the embryo itself, which would be a great progress. In summary, we must optimize the results and reduce the risks.

It is also interesting to improve the efficiency of the treatments. Not only increase the pregnancy rate, if not keep it with the transfer of a single embryo. It is convenient to avoid multiple gestation since it has serious economic and health repercussions on the mother and children.

For the reduction of the number of embryos transferred, embryos with greater implantation potential should be identified in each case. The Embryoscope is a technique focused on fulfilling this objective.

On the other hand, it must also be determined what has caused the multiple gestation in each patient. For this reason, to decide the number of embryos to be transferred, the following must be taken into account: the age of the woman, the embryos available when the transfer is to be made, and the number of in vitro fertilization cycles that have been carried out previously.


assisted reproduction in (Spain)

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