ROSI Round Spermatid Injection in Tbilisi, Georgia
At Clinic Atlas in Tbilisi, we review the medical history of patients facing severe male infertility and explain the options relevant to their circumstances.Round spermatid injection, known as ROSI, is an experimental technique investigated in selected cases where mature sperm cannot be identified. It should not be presented as a routine alternative to ICSI or a guaranteed route to having a biological child.
What Is Round Spermatid Injection?
Understanding Round Spermatids
Round spermatids are immature male reproductive cells found within testicular tissue. They represent a stage of development before mature sperm are formed.Unlike mature sperm, these cells have not developed the characteristic structure needed for normal fertilization.
How ROSI Differs from ICSI
In conventional ICSI, a mature sperm is injected into an egg. In ROSI, a round spermatid is used instead.The procedures may involve similar laboratory equipment, but their biological requirements and clinical evidence differ considerably.
Is ROSI an Established Fertility Treatment?
No. ROSI remains experimental, with limited and variable evidence concerning effectiveness and safety.Published births demonstrate that pregnancy is possible in some circumstances. They do not establish that ROSI is consistently effective across laboratories or appropriate for every patient without mature sperm.
When Might ROSI Be Discussed?
Selected Cases of Non Obstructive Azoospermia
Non obstructive azoospermia is a condition in which sperm are absent from the semen because sperm production is severely impaired.Some patients may still have small areas of sperm production within the testes. Specialist assessment is therefore important before conclusions are drawn about available reproductive cells.
After an Unsuccessful Search for Mature Sperm
ROSI may enter discussion when a surgical sperm search does not identify mature sperm but suitable round spermatids are thought to be present.An unsuccessful retrieval does not automatically establish that ROSI is possible. The tissue findings and reliability of cell identification require careful review.
Does Every Patient with Azoospermia Have Round Spermatids?
No. The absence of sperm in semen does not confirm that usable round spermatids exist in testicular tissue.Some patients may have no suitable reproductive cells available. We explain this possibility before further procedures are considered.
How Do We Assess Your Circumstances?
Reviewing Previous Investigations
We review semen analysis results and any previous sperm retrieval, laboratory or pathology reports.Your medical history and the findings from earlier procedures help determine which additional assessment may be appropriate.
Hormonal and Genetic Evaluation
Assessment may include hormone testing and relevant genetic investigations, such as chromosome analysis or testing for Y chromosome microdeletions.The results can affect treatment recommendations and may identify implications for your health or future children.
Specialist Counseling
We explain the distinction between established sperm retrieval and ICSI approaches and experimental procedures such as ROSI.Where a genetic finding is identified, counseling helps clarify inheritance risks and the limitations of available testing.
How Is ROSI Performed Where Appropriate?
Tissue Assessment and Cell Identification
Testicular tissue is examined for mature sperm and other reproductive cells. Correct identification of round spermatids is technically challenging.A proposed ROSI procedure requires appropriate laboratory expertise, clinical oversight and confirmation of applicable legal and ethical requirements.
Egg Collection and Laboratory Injection
The person providing eggs undergoes the relevant IVF preparation and egg collection.Where a procedure proceeds, an identified round spermatid is injected into a mature egg. Neither the presence of a spermatid nor successful injection guarantees fertilization.
Assisted Egg Activation
ROSI protocols may include assisted egg activation because round spermatids do not activate eggs in the same way as mature sperm.This is an additional laboratory intervention with its own evidence limitations. It should be explained separately rather than described as a guaranteed solution.
Embryo Development and Possible Transfer
Injected eggs are monitored for fertilization and development. A cycle may produce no embryo suitable for transfer.If transfer is considered, the clinical team explains the findings and subsequent monitoring. An embryo’s appearance cannot establish that it will result in a healthy child.
What Does the Research Show?
Pregnancies and Births Have Been Reported
Published studies describe pregnancies and births following ROSI. However, results vary widely and the evidence includes small studies with important methodological limitations.Overall outcomes have generally been less favorable than those reported with mature sperm used for ICSI.
Individual Chances Cannot Be Assumed from a Study
A reported pregnancy rate among patients who reached embryo transfer does not describe the chance of success for everyone beginning assessment.Some patients do not reach injection, fertilization or transfer. We distinguish these stages when discussing research rather than present one percentage as a personal prediction.
Long Term Safety Remains Uncertain
Available information about children born after ROSI is limited, particularly for uncommon conditions and outcomes that emerge later in life.Reassuring findings in a small group cannot exclude all possible risks.
Can Embryo Genetic Testing Remove These Uncertainties?
No. Embryo genetic testing can investigate specific findings, but it cannot exclude every genetic, developmental or other potential risk associated with an experimental procedure.Testing should not be presented as proof that ROSI is safe.
What Other Options Should Be Discussed?
Reviewing Established Treatment Possibilities
A specialist may review whether another sperm retrieval assessment is justified. Repeating surgery is not automatically beneficial and requires consideration of previous findings and medical risks.
Donor Sperm and Other Reproductive Decisions
Donor sperm may be an alternative for some patients. We discuss its medical and personal implications without pressure.You may also decide not to pursue further treatment. Counseling can support decisions that reflect your values and circumstances.
Planning a Consultation at Clinic Atlas
Share Your Existing Reports Before Making Plans
Contact us with details of previous investigations so we can explain what information is needed for review.A consultation does not automatically confirm eligibility or the availability of a ROSI procedure.
Understand the Proposed Costs and Limitations
Before agreeing to any further investigation or treatment, ask what the quotation includes and what happens if suitable cells or embryos are not identified.We encourage informed decisions based on realistic expectations rather than promises of success.
Discuss Severe Male Infertility with Clinic Atlas
Contact Clinic Atlas in Tbilisi, Georgia, to discuss your medical history and the assessment relevant to severe male infertility.We can help you understand the difference between established treatment options and experimental approaches, including ROSI.
