Piezo-ICSI

What is Piezo-ICSI?

• During an IVF cycle, eggs are combined with sperm either via mixing them in a dish (standard IVF) or injecting one sperm into each egg (ICSI).
• During conventional ICSI, a single sperm is picked up with a sharp pipette and injected into the egg.
• The process of piercing the external membrane of the egg (known as the zone pellucida) with a sharp pipette can sometimes damage the egg. This happens about 5-10% of the time.
• Piezo-ICSI is a type of ICSI that uses a special pipette. The piezo pipette has a blunt tip (instead of a sharp tip) and it is connected to an electric machine that makes the pipette vibrate. This approach is considered more gentle and may be less likely to damage the egg than conventional ICSI.
• Conventional ICSI and Piezo-ICSI are both performed in the same controlled and safe environment.

Why might Piezo-ICSI improve IVF outcomes?

• Piezo-ICSI is thought to be a gentler or softer approach to sperm injection during ICSI.
• Some studies suggest that Piezo-ICSI is less likely to damage eggs and more likely to fertilise eggs than conventional ICSI.

Why might Piezo-ICSI not improve IVF outcomes?

• Conventional ICSI is a reliable method for fertilising eggs, and damage to eggs is uncommon, occurring in about 3–10% of cases.
• Fertilisation and embryo development are mainly determined by egg quality, sperm quality, and maternal age, not just how the sperm enters the egg. Therefore, Piezo-ICSI may not be expected to make much difference to the chance of IVF success.
• Like many laboratory techniques, the outcome may depend on the technical skills and experience of the embryologist. If the Piezo-ICSI procedure is not performed correctly, it may make no difference, or it may damage the egg.

Who might consider Piezo-ICSI for IVF?

People who have experienced:

• Failed fertilisation or low fertilisation rates
• Women of advanced age (e.g. over 38)
• Previous history of high rate of egg degradation after ICSI

Learn more about common IVF issues and challenges

Does Piezo-ICSI work? What the evidence says

There is no randomised controlled trial evidence that assesses the safety or effectiveness of Piezo-ICSI. This means we don’t know whether Piezo-ICSI increases the chance of getting pregnant and having a baby from IVF. Therefore, we cannot say whether or not Piezo-ICSI works.

Side effects of Piezo-ICSI

• Side effects are not usually relevant for lab-based optional extras like Piezo-ICSI.

Risks of Piezo-ICSI and long-term outcomes

• It is unknown whether Piezo-ICSI poses any risk of harm to the IVF patient, embryo or baby.

Piezo-ICSI has been used in Australia since 2019, and approximately 2,000-3,000 IVF cycles have used Piezo-ICSI.

Cost of Piezo-ICSI

Piezo-ICSI usually costs between $250 - $450 AUD per ICSI cycle. This is in addition to the cost of an ICSI cycle, which is normally more than the cost of standard IVF. There is no Medicare rebate available for Piezo-ICSI.

Cost information is indicative only, costs can vary from clinic to clinic and depending on different circumstances.

Practical considerations

• Piezo-ICSI is a laboratory procedure performed by the embryologist. It does not create any extra procedure or burden on the IVF patient.
• Piezo-ICSI can be used by the embryologists at the time of ICSI (sperm selection and injection). You can only use piezo-ICSI if you are already planning to use ICSI (rather than standard IVF)
• Piezo-ICSI is not currently approved for use in Australia by the Therapeutic Good Administration (TGA) which is the Australian authority that approves medicines and devices. This means it can only be accessed through a clinical trial or IVF clinics that have been granted specific permission to use it from the TGA – it is not available at all IVF clinics.

Unsure about some of the terms we have used? Use our glossary to understand scientific or unfamiliar terms.