IMSI & PICSI in Delhi
Advanced sperm selection at very high magnification, or by binding affinity, before injection.
What IMSI & PICSI involves
IMSI examines sperm at magnifications above 6,000x to detect vacuoles and structural defects invisible at routine magnification. PICSI selects sperm by their ability to bind hyaluronan, mimicking what happens naturally at the egg's outer layer.
Both are refinements of ICSI, used selectively rather than routinely. We recommend them where sperm morphology is severely abnormal, where DNA fragmentation is high, or after repeated poor embryo quality with no other explanation.
Who this is for
- Severe teratozoospermia with very low normal forms
- High sperm DNA fragmentation index
- Repeated poor embryo development in previous cycles
- Recurrent miscarriage with a suspected sperm contribution
Not everything on this list means you need this treatment. The workup comes first, and the recommendation follows from what it shows — not from what was booked before you arrived.
Step by step
DNA fragmentation testing
We confirm the problem before adding the technique, rather than applying it to everyone.
High-magnification assessment
Sperm are graded on head and vacuole morphology at ultra-high magnification.
Selection
The best-graded or hyaluronan-bound sperm are picked for injection.
Standard ICSI onwards
Injection, culture and transfer proceed exactly as in a normal ICSI cycle.
Your results, in writing
Whatever the outcome of IMSI & PICSI, you leave each stage with the findings written down — what was done, what was found, what it means, and what the options are from here. Reports are issued the same day wherever the laboratory allows it.
Case study: Good eggs, poor embryos, and a sperm explanation
33, Green Park · two IVF cycles with poor embryo development
What she came in with
Two cycles that collected plenty of eggs — fourteen and twelve — with good fertilisation rates, but almost no embryos surviving past day three. She had been told it was 'egg quality' and offered donor eggs.
What the workup showed
Egg quality was hard to reconcile with her age and reserve. A sperm DNA fragmentation test came back at 41%, very high. Morphology showed 0% normal forms with extensive head vacuolation on high-magnification assessment.
What we did
Three months of antioxidant therapy and treatment of a low-grade genitourinary infection brought fragmentation to 22%. The next cycle used IMSI, selecting sperm at high magnification and rejecting those with head vacuoles.
Outcome
Eleven eggs, eight fertilised, five reached good-quality blastocyst — the first time embryos had survived to day five. A pregnancy followed on the first transfer.
The point of this case
Embryo arrest is routinely blamed on the egg. Paternal DNA takes over at the four-to-eight cell stage, which is exactly when these embryos were stopping.
Illustrative case. This is a composite of presentations commonly seen in this practice, written for explanation — it is not the record of an identifiable patient, and no individual's details are used. Outcomes vary, and nothing here is a prediction of what will happen in your case.
What is different about having this done here
Offered only where the indication is documented
DNA fragmentation testing available in-house
Combined with antioxidant therapy and lifestyle correction for the male partner
Costed separately and transparently so you can decline it
Treated by the consultant, not by a rotating team
Dr. Tiwari performs the scans, the procedure and the follow-up herself, and looks after any pregnancy that results. Over a long treatment course that continuity is the difference between being known and being processed.
- MBBS, MS (Obstetrics & Gynaecology), FNB (Reproductive Medicine)
- Over ten years in reproductive medicine and gynaecological surgery
- Consultations and scans at Mother's Hope, Katwaria Sarai; theatre work at SHE Delhi Hospital, Greater Kailash II
- Itemised costs given in writing before anything begins
Areas we see patients from
Both locations are in South Delhi. Patients travelling from further out have appointments grouped to cut down the number of trips.
Questions about IMSI & PICSI
Is IMSI worth the extra cost?
In unselected couples, no. In men with severe morphology defects or high DNA fragmentation, there is reasonable evidence of improved embryo quality. We will tell you which group you are in.
What is a normal DNA fragmentation index?
Below 15% is generally considered normal, 15–30% intermediate and above 30% high. High results usually prompt antioxidant treatment and a repeat test before the cycle.
Talk it through before you commit
Consultations run for a full hour. Bring any previous reports — they are reviewed properly, not repeated.