ICSI Overview: Hitting the Bull's Eye

ICSI overview ICSI overview

Intracytoplasmic sperm injection, or ICSI for short, is a procedure where your partner’s sperm is injected directly into your egg(s) for fertilization with IVF. You may have questions about using ICSI with IVF for male infertility and we are here to help. Here are some answers to common questions about ICSI.

How can ICSI help me get pregnant?
The ICSI procedure can help you and your partner get pregnant despite certain male infertility problems, like the following:

  • Sperm unable to penetrate or fertilize an egg
  • Low sperm count or poor sperm quality
  • A blockage or anatomical abnormality in the male's reproductive tract that prevents him from producing or ejaculating sperm
  • Men who require a testicular or epididymal biopsy in order to conceive (such as after a vasectomy)
  • Couples who did not have a successful fertilization in a previous IVF cycle

What to expect with ICSI
ICSI fertility treatment takes place during the fertilization phase of the IVF process. If you choose to use the ICSI procedure with IVF, here is what you can expect:

  1. After your egg retrieval, your partner will provide a fresh sperm sample, or your clinic may prefer to use frozen sperm. If your partner is unable to produce a sperm sample, your doctor may perform a procedure called needle aspiration to retrieve the sperm.
  2. Back in the laboratory, while holding a mature egg with a special tool, a single sperm will be injected directly into the cytoplasm (the center) of the egg using a small needle.
  3. If the fertilization is successful, after about 3 to 5 days, the growing fertilized egg is placed into your uterus for implantation.

After a two-week wait, you will find out if you are pregnant.

ICSI success rates
In 2011 over half of all IVF cycles performed in the U.S. used ICSI. And, the vast majority (88 percent) of couples dealing with male factor infertility used ICSI with their IVF cycles.

Here are the 2011 live birth IVF success rates per fresh embryo transfer from couples diagnosed with male factor infertility. Remember, most of these couples (88 percent) chose ICSI along with IVF.

  • Women 35 and younger: 48.3 percent gave birth 
  • Women 35 to 37: 42 percent
  • Women 38 to 40: 29.8 percent
  • Women 41 to 42: 20.4 percent
  • Women over 42: 7 percent

Risks of ICSI
There are some risks to using ICSI with IVF. For instance:

  • ICSI can damage healthy eggs during the process.
  • IVF (with or without ICSI) increases the risk of becoming pregnant with multiples. Couples that use IVF have a 30 to 35 percent risk of having twins and a 5 to 10 percent risk for triplets or more.
  • Some theorize that there is a greater chance for genetic syndromes or birth defects following procedures like ICSI that manipulate sperm and eggs. Some studies suggest evidence of an increased incidence of certain birth defects. However, this risk is minimal. Unfortunately, since ICSI is a relatively new procedure, there is little known about the long-term side effects of the treatment.

Yes, there are some risks to ICSI, but there are also many benefits to using ICSI. If your partner has male factor infertility, your doctor may recommend ICSI with IVF to help you get pregnant.

Ask a doctor in your area about ICSI

  • American Society for Reproductive Medicine. Patient Fact Sheet: Intracytoplasmic Sperm Injection.
  • American Pregnancy Association: Intracytoplasmic Sperm Injection: ICSI.
  • Society for Assisted Reproductive Technology: 2011 Clinic Summary Report