This method consists in the intracytoplasmic injection of spermatozoa, which is selected as a result of a two-stage screening: morphological and physiological. Therefore, this method combines IMSI and PICSI.

In addition to a very thorough morphological selection, the sperm is also assessed for its ability to bind to hyaluronic acid. A normal mature sperm cell is introduced into an egg. This method is used when other methods fail to bring the expected outcomes, as well as in the case of high sperm chromatin fragmentation, abnormal HBA results and a high percentage of sperm with abnormal structure.

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