ICSI Procedure

Thanks to the wonders of science, doctors can now inject a single, tiny sperm directly into an egg during a procedure called intracytoplasmic sperm injection (ICSI). This procedure may increase your chances of success with IVF.

The ICSI process explained
The intracytoplasmic sperm injection process takes place during IVF. It is often performed for couples that are dealing with male factor infertility and for those who have not had success with IVF in the past.

There are five main steps to the ICSI procedure:

  1. A sperm sample is taken from your partner’s semen or surgically extracted from his testes or epididymis.
  2. Your eggs are surgically extracted from your ovaries.
  3. Using a tiny hollow needle, one sperm is carefully injected into an egg.
  4. After injection, the fertilized egg is observed for growth and development.
  5. Once normal growth is observed, the embryo will be implanted into your uterus where it has a chance to implant and grow.

Some fertility clinics choose to use fresh sperm that have just been extracted, while others prefer to do the ICSI procedure with frozen sperm. There appears to be no difference in pregnancy rates between those who use fresh or frozen sperm during the ICSI process.

How ICSI works
The ICSI procedure is performed by using a technique called micromanipulation.Micromanipulation uses a special microscope, along with very small surgical tools, to pick up and handle one single sperm, injecting it directly into an egg.

ICSI and male infertility
The ICSI procedure can help you achieve IVF pregnancy success even when male infertility problems are an issue. If your male partner has experienced any of the following problems, talk to your doctor about ICSI:

  • Absence of sperm in the semen, possibly caused by a blockage
  • Low sperm count, poor sperm quality and/or abnormal sperm shape and movement
  • Sperm unable to penetrate through the outer layer of your egg or production of antisperm antibodies

Have you tried IVF without success? If so, ask your doctor about ICSI and IVF success rates.

ICSI side effects
Unfortunately problems can occur during ICSI procedures. Here are some potential issues that could arise during the process:

  • Your eggs may become damaged.
  • The embryo might fail to grow after the fertilization.
  • Some people speculate that the ICSI process might lead to higher rates of genetic defects compared to other fertility treatments. But, the birth defects most commonly associated with ICSI can usually be fixed with surgery.

ICSI and vasectomy reversal
If your partner has had a vasectomy, the ICSI procedure may help you conceive. This may be especially helpful if your partner tried to have a vasectomy reversal that was unsuccessful, or if he doesn’t want to have the vasectomy reversed. During a vasectomy reversal or in a quick office procedure, a surgeon is often able to remove your partner’s sperm from his testes. These sperm can be frozen for later use with IVF and ICSI.

ICSI is a major advance
It is quite amazing that doctors and scientists have made such amazing breakthroughs with assisted reproductive technology fertility treatments. It is fascinating that we now have the ability to fertilize an egg with just one sperm, helping many infertile couples get pregnant.



  • American Pregnancy Association: Intracytoplasmic Sperm Injection: ICSI.
  • American Society of Reproductive Medicine: The management of infertility due to obstructive azoospermia. Vasectomy Reversal. Intracytoplasmic Sperm Injection (ICSI)
  • American Urological Association, Inc.: Report on Management of Obstructive Azoospermia. Getting Help for Obstructive Azoospermia