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This is a special culture medium that contains natural growth factors. This additive may be beneficial for embryos from women who have already experienced miscarriages or biochemical pregnancy (an extended cycle where the embryo makes contact with the endometrium but the pregnancy does not continue). It can also be indicated in some cases where the repeated transfer of normally developed embryos has not led to pregnancy.
Occasionally, semen can contain a high proportion of immature sperm or sperm with a high DNA fragmentation index (see SDI test). To prevent such sperm from being used for ICSI, mature and DNA-intact sperm are selected by binding to hyaluronic acid. This binding is comparable to the process that naturally takes place at the zona pellucida. Thus the development potential of the resulting embryos is improved.
Even after the use of ICSI, egg fertilisation rate may be very low or absent. In some cases, this problem can be overcome in the next cycle with the use of calcium ionophore. This causes changes in the calcium levels of the injected egg cell, corresponding to those that occur during the normal fertilisation process. This can result in an improved fertilisation rate.
Before implantation into the endometrium, the embryo is contained within a protective shell, the zona pellucida. In order for implantation to occur, the embryo must leave this shell - or “hatch”. In rare cases, the protective shell is thicker than usual, which can lead to impaired hatching. In these cases, it may be helpful to open the shell artificially - the embryo then hatches through this opening.
This term refers to the evaluation and selection of sperm for ICSI under ultra-high magnification. A few clinics claim that the use of this technique leads to higher pregnancy and lower miscarriage rates. However, this has not been confirmed in larger studies.