PICSI is an extension of Intra-cytoplasmic sperm injection (ICSI) and stands for Physiological Intra-Cytoplamsic Sperm Injection (PICSI). Similarly to ICSI, it involves the selection of motile sperm for injection, but rather than simply using conventional visual cues (morphology and motility), it involves selecting mature sperm which bind to hyaluronic acid. Hyaluronic acid is a major component of the cumulus complex which surrounds the egg/oocyte and provides a selective barrier that excludes functionally deficient sperm during fertilisation in vivo (within the body).

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