Intracytoplasmic Sperm Injection (ICSI) is the procedure of choice for male factor infertility cases. The reason is that a single pre-selected sperm cell (spermatozoon) is injected directly into the egg, making it possible for men with very little sperm or very poor sperm quality to father children.

An ICSI procedure requires mature egg cells just like conventional in-vitro fertilization (IVF), so most female patients undergo hormonal stimulation

Ovarian Hyperstimulation (COH) – (1)) in order to produce as many mature eggs as possible.

On the day of the egg retrieval (Egg Retrieval– (2)) the male partner has to produce a semen sample (Semen Sample Collection– (3)), although the procedure can be done with frozen sperm as well. Depending on the type of male factor infertility, the male partner might have to undergo micro-surgical sperm retrieval (PESA, MESA, TESA or TESE) in order to retrieve sperm cells.

Once it is processed, the sperm sample is examined under the microscope and a single sperm cell is chosen, based on its morphology (shape) and motility (movement). The sperm cell is then injected into a mature oocyte (ICSI – (4)), whose development is monitored. The best embryos are selected for transfer into the female patient’s uterus (Embryo Transfer– (5)). All remaining viable embryos can be frozen for later use.

ICSI is recommended for couples in which:

✓ The male partner has abnormal sperm parameters

✓ Previous low or no fertilization rates using conventional in-vitro fertilization (IVF)