Kishori IVF


IntraCytoplasmic Sperm Injection (ICSI)

In cases of infertility, intracytoplasmic sperm injection (ICSI) can help achieve pregnancy, especially when male infertility is a factor. During this form of IVF, sperm is directly injected into the egg by a healthcare provider to assist with conception. Pregnancy can occur following the transfer of the embryo.


What is intracytoplasmic sperm injection (ICSI)?

Intracytoplasmic sperm injection(ICSI) is a treatment for infertility where live sperm is injected into a person’s eggs in a lab. This process can result in an embryo. ICSI is a type of IVF, often used when male infertility impacts someone’s ability to conceive.

What does intracytoplasmic mean?

Intracytoplasmic means that the sperm injection happens inside the egg’s cytoplasm. This is the jelly-like substance at the center of an egg, made of water, salt, and other molecules.

How is ICSI different from IVF?

ICSI is a type of IVF. In traditional IVF, thousands of sperm are placed near an egg in a dish, and fertilization happens by chance. But with ICSI, a single sperm is directly injected into a single egg, increasing the chance of fertilization. However, fertilization is not guaranteed.

In both ICSI and traditional IVF, the fertilized egg (embryo) is implanted into the uterus. Pregnancy occurs if the embryo attaches to the uterine lining.

What is assisted reproductive technology (ART)?

Assisted reproductive technology (ART) includes both ICSI and IVF, which are used to help treat infertility. ART involves fertility treatments done in a lab using eggs and sperm to initiate pregnancy outside of the body.

How successful is intracytoplasmic sperm injection?

Around 6 out of 10 IVF procedures involve ICSI. The chances of a successful pregnancy with ICSI are similar to those with traditional IVF. Typically, 50% to 80% of ICSI attempts result in fertilization.

Who needs ICSI?

ICSI is most beneficial for individuals experiencing male infertility. Your doctor may suggest ICSI if you have:

Difficulty ejaculating:

  • Blockages in the male reproductive system.
  • Low sperm count or poor sperm quality.
  • Semen flowing backward into the bladder.

You might also require ICSI if:

  • Traditional IVF hasn’t resulted in embryo creation.
  • The egg provider is over 35.
  • You’re using previously frozen eggs or sperm for conception.

Procedure Details

Who performs intracytoplasmic sperm injection?

You might visit an Ob/Gyn who specializes in reproductive endocrinology. These doctors focus on diagnosing and treating conditions related to the endocrine system that affect reproduction, including infertility and fertility preservation.

What happens before ICSI?

Before ICSI, your healthcare provider needs to collect eggs and sperm.

Here’s what happens during egg retrieval:

Ovulation induction (also known as ovarian stimulation): 

The person providing the eggs receives injections of medication for eight to 14 days. This stimulates the ovaries to produce multiple mature eggs. Later, an injection of Lupron or human chorionic gonadotropin (hCG) helps with the final maturation of the eggs.

Egg retrieval: 

Using transvaginal ultrasound, your healthcare provider guides a thin needle through the vaginal wall into the ovaries. This is done with a mild anesthetic, so you won’t feel any pain. A suction device connected to the needle is used to collect the eggs.

If fresh sperm is being used, it’s collected on the same day as egg retrieval. Here’s how it’s done:

  • The person providing the sperm abstains from sex and masturbation for two to three days before collection.
  • They masturbate at home or in a private room at the clinic, collecting the ejaculate in a container provided by the lab. The sample must reach the lab within 60 minutes.
  • A semen analysis is immediately performed to check sperm volume, mobility, and quality. Individuals with conditions like azoospermia, anejaculation, or retrograde ejaculation may need special procedures to collect sperm. This applies to those who have had an unsuccessful vasectomy reversal as well. Procedures such as electroejaculation and microscopic testicular sperm extraction may be done in a hospital rather than a fertility clinic. The lab may freeze and store the sperm for later use in IVF at the clinic.

What happens during intracytoplasmic sperm injection?

During ICSI, your healthcare provider:

  • Uses a pipette (a small glass tube with a suction bulb) to hold the mature egg in place on a lab dish.
  • Immobilizes and picks up one sperm using a thin needle.
  • Inserts the needle into the egg to reach the cytoplasm.
  • Inject the sperm into the cytoplasm.
  • Withdraws the needle from the egg.

What happens after ICSI?

After ICSI, your healthcare provider monitors the fertilized egg in the laboratory to check for signs of successful fertilization. Typically, within five to six days, a healthy fertilized egg divides into cells, forming a blastocyst. Your healthcare provider evaluates the size and cell mass of the blastocyst to determine the optimal time for a potential pregnancy.

An embryo transfer usually occurs on the fifth or sixth day following the egg retrieval procedure. However, in some cases, the transfer may be delayed for months or even years. Your doctor will discuss the timing of the embryo transfer with you. Using ultrasound technology, your healthcare provider inserts a long, thin tube called a catheter into your vagina and injects the embryo into your uterus. For pregnancy to occur, the embryo needs to attach to the uterine wall. Your healthcare provider may advise waiting at least two weeks before taking a pregnancy test.

Risks / Benefits

What are the benefits of intracytoplasmic sperm injection?

Compared to traditional IVF, ICSI appears to be more successful in helping individuals with male infertility become parents. Some centers use ICSI for all patients, regardless of infertility diagnosis.

What are the risks of ICSI?

These complications may occur with ICSI:

  • Damage to some or all of the eggs during needle penetration.
  • Failure of the egg to fertilize after sperm injection.
  • Stopping of embryo development in the lab or after embryo transfer.

What are the risks of ICSI to the baby?

In the United States, approximately 2% of babies are born with congenital conditions. An additional 1% of children conceived with ICSI have congenital conditions. Medical experts believe that the underlying cause of infertility may contribute to these issues rather than the fertility treatment itself. Additionally, this risk is relatively low considering that birth defects occur in 2% of newborns every year.

ICSI may slightly increase a child’s risk of:

  • Angelman syndrome.
  • Autism.
  • Beckwith-Wiedemann syndrome (a growth disorder).
  • Disorders of sex differentiation.
  • Hypospadias.
  • Intellectual disabilities.

Additional Details

Does ICSI raise the likelihood of having twins, triplets, or more?

To improve the chances of a successful pregnancy, your healthcare provider might utilize ICSI to fertilize multiple eggs. If you opt to transfer more than one embryo, you may end up carrying twins, triplets, or even more babies. A multiple pregnancy can heighten the risk of premature birth and other complications for both the parent giving birth and the babies.

"A note from Kishori IVF Clinic"

If you or your partner are facing challenges in conceiving, your healthcare provider might suggest intracytoplasmic sperm injection (ICSI). This form of in vitro fertilization (IVF) is particularly beneficial when male infertility is a concern. ICSI includes several steps: stimulating and retrieving eggs, collecting sperm, creating embryos in a lab, and eventually transferring embryos. Have a discussion with your healthcare provider to determine if ICSI is the suitable fertility treatment for you.