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PICSI complements ICSI with an additional sperm selection step: preference is given to mature sperm that can bind to hyaluronic acid. The procedure may be considered as an additional method, particularly in cases of abnormal sperm quality, increased DNA fragmentation, recurrent miscarriages, or after previous unsuccessful treatments.
NAD⁺ is an endogenous coenzyme that plays a crucial role in cellular energy metabolism and mitochondrial function. Preclinical studies suggest a possible significance of NAD⁺ metabolism for oocyte function; however, whether NAD⁺ infusions can improve egg quality or pregnancy chances in humans has not yet been sufficiently investigated.