Intra-Cytoplasmic Sperm Injection (ICSI)

What is ICSI?

ICSI was developed in 1991 and the first baby conceived following ICSI technique was born in 1992.

ICSI is a technique that has been developed to assist fertilisation when sperm quality is particularly poor. Intra-cytoplasmic sperm injection (ICSI) involves injecting a single sperm directly into an egg in order to fertilise it. The fertilised egg (embryo) is then transferred to the woman’s womb. The procedure for ICSI is similar to that of IVF, but instead of fertilisation taking place in a dish, the embryologist selects sperm from the sample and a single sperm is injected directly into each egg. The injected eggs are checked the day after to see if fertilisation has occurred.

ICSI is a time-consuming procedure. It requires skill and high technology equipment. The whole process is done under microscopic visualization and manipulation. Before the sperm is injected into the egg, it is immobilised. The egg is held in place and the sperm is injected into the egg by puncturing a tiny hole in the zonapellucida of the egg using a micro injection needle. The needle will go through this hole and deliver the sperm in the cytoplasm. The tiny hole will seal by itself and recover.

When is ICSI used?

ICSI is often recommended if:

  • The patient has a very low sperm count.
  • The patient has a very low sperm motility (movement).
  • The patient has poor sperm morphology (abnormally shaped).
  • The patient’s sperm has been collected from the testicles or epididymis.
  • There are high levels of antibodies in the semen.
  • During previous IVF attempt, there was either failure of fertilisation or an unexpectedly low fertilisation rate.
  • The patient has had problems obtaining an erection and ejaculating.
  • The patient sperm count is zero and donor insemination is not wanted.


What are the disadvantages of ICSI?

  • Not all eggs collected may be of suitable quality or mature enough to undergo the injection procedure.
  • Due to the nature of the procedure, on average, 10% of the eggs will be damaged and therefore cannot fertilise.
  • It is possible that none of the eggs will be suitable for ICSI.
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