Intracytoplasmic Sperm Injection (ICSI) is performed by injecting a single sperm into a mature oocyte to achieve fertilization. This is one of the most commonly used assisted reproduction techniques (ART).

The ICSI technique has not undergone substantial alteration since it first came into use because of its excellent and consistent success rates in achieving fertilization (70-80%). The essential tools include an inverted microscope with specialized optics and a heating stage to keep the temperature at 37 °C (98 °F).

Several micromanipulators are attached to the microscope to move the (holding arm) micropipettes holding the oocyte and the (injecting arm) containing the sperm.
Sperm motility and the experience of the embryologist applying the technique are two of the most important parameters to guarantee its effectiveness.

When is ICSI advised? 
Advising ICSI should follow from a comprehensive fertility assessment of both partners.

For instance:

  • Severe male infertility factors which includes
    • Marked oligoasthenoteratozoospermia: this is a condition that includes low
      number of sperm, poor sperm movement and abnormal sperm shape
    • Severe teratozoospermia:
  • Desired sex selection for family balance (Male or Female child)
  • Obstructive azoospermia: A total absence of sperm in the ejaculate due to an
    obstruction. The most common causes are genetic disorders, inflammation and failed
  • Testicular azoospermia: A total absence of sperm in the ejaculate due to a disorder of
    sperm production in the testicles.
  • Anejaculation: Ejaculatory dysfunction caused by retrograde ejaculation or paraplegia.

In cases of azoospermia and anejaculation, the sperm needed for ICSI can be retrieved directly
from the testicles (by testicular puncture or biopsy).

  • Immune cause: the presence of high levels of anti-sperm antibodies.
  • Valuable sperm samples: patients who freeze their sperm sample before undergoing chemo- or radiotherapy, patients who require sperm washing because they have an infectious disease (HIV, hepatitis) or use donor semen.


  • Failing to achieve pregnancy after several standard IVF cycles.
  • Performing PGS/PGT-A/CCS or DGP.
  • Vitrified oocyte microinjection.



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