Many IVF and fertility practices such as ours use a procedure called PICSI to help certain couples where we are concerned that there may be a problem with sperm quality even when fertilization is succesful with ICSI. PICSI relies on placing the sperm on a field hyaluronic acid and having the embryologist determine whether sperm are able to bind to it. Sperm which are immature or otherwise abnormal are less likely to bind to the hyaluronic acid, and so sperm which do bind to it are used for the injection into the egg for ICSI. We and others have found that it may help certain couples who have failed ICSI cycles or had miscarriages from ICSI cycles. However, to date there are no large studies yet showing how effective it is, so researchers at the University of Leeds in the UK have initiated a large study to determine this.