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Intracytoplasmic sperm injection
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==Sperm selection== Before performing ICSI, sperm ''in vitro'' selection and capacitation has to be done. Apart from the most common techniques of ''in vitro'' sperm [[capacitation]] (swim-up, density gradients, filtration and simple wash), some new techniques are useful and have advantages over older methods. One of these new techniques is the use of microfluidic chips, like Zymot ICSI chip invented by Prof. [[Utkan Demirci]]. This chip is a device that helps identify the highest quality spermatozoa for the ICSI technique. It reproduces the conditions of the vagina, resulting in a more natural spermatozoa selection. One of the main advantages of this method is spermatozoa quality, as the selected ones have better motility, morphology, little DNA fragmentation and less quantity of reactive oxygen species (ROS).<ref>{{cite web |title=ZyMōt ™ICSI |url=http://cimabiberica.es/zymot-icsi/ | location = Barcelona, Spain | work = Fertil Ibérica |language=es}}</ref> Another way to perform the selection is the MACS technique, which consists of tiny magnetic particles linked to an antibody ([[annexin V]]) which is able to identify more viable spermatozoa. When the semen sample is passed through a column with a magnetic field, apoptotic respermatozoa are retained in the column while the healthy ones are easily obtained at the bottom of it.<ref>{{cite web |url=https://ivi.es/tratamientos-reproduccion-asistida/macs/#:~:text=La%20t%C3%A9cnica%20de%20MACS%20consiste,separarlos%20de%20los%20espermatozoides%20sanos.|title = MACS, técnica de reproducción asistida | work = IVIRMA | location = Valencia, Spain | language = es }}</ref> PICSI is another method derived from this one, the only difference is the selection process of the spermatozoa. In this case, they are placed on a plate containing drops of a synthetic compound similar to [[hyaluronic acid]]. We will know which spermatozoa are mature because they will bind to the HA drops. This is because only mature sperm have a receptor for hyaluronic acid, which they need because this acid can be found surrounding the oocytes, and sperm need to be able to bind to this acid and digest it in order to fertilize the oocyte. After the mature spermatozoa have been selected, they can be used for the microinjection of oocytes.<ref name="pmid20041286">{{cite journal | vauthors = Parmegiani L, Cognigni GE, Ciampaglia W, Pocognoli P, Marchi F, Filicori M | title = Efficiency of hyaluronic acid (HA) sperm selection | journal = Journal of Assisted Reproduction and Genetics | volume = 27 | issue = 1 | pages = 13–6 | date = January 2010 | pmid = 20041286 | pmc = 2826621 | doi = 10.1007/s10815-009-9380-0 }}</ref> Sperms selected by hyaluronic acid has about no effect on whether a live birth results, but may reduce miscarriage.<ref>{{cite journal | vauthors = Lepine S, McDowell S, Searle LM, Kroon B, Glujovsky D, Yazdani A | title = Advanced sperm selection techniques for assisted reproduction | journal = The Cochrane Database of Systematic Reviews | volume = 7 | issue = 7 | pages = CD010461 | date = July 2019 | pmid = 31425620 | pmc = 6699650 | doi = 10.1002/14651858.CD010461.pub3 }}</ref>
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