Intra Cytoplasmic Sperm Injection (ICSI) technique, which revolutionized the treatment of male infertility, is used to fertilize mature eggs in the event of sperm or egg abnormalities. In this procedure, the embryologist picks up a single sperm under the microscope and injects it directly into the cytoplasm of the egg, using a small glass needle.

ICSI allows couples with very low sperm counts or poor quality sperm to achieve fertilization. It is also recommended for couples who have not achieved fertilization in prior IVF attempts. Special urological procedures are available for patients where it is difficult to obtain sperm or for men with no sperm in the ejaculate.

The process of ovarian stimulation, ovulation induction, embryo culture and embryo transfer are all the same as in conventional in vitro fertilization. Only the insemination procedure differs. In IVF, the egg and the sperms are incubated together so that fertilization happens by itself and in ICSI the embryologist manually injects a single sperm into a single egg.

Indications for ICSI

• Severe male-factor infertility
• Fertilization failure after standard IVF treatment
• Number of spermatozoa in the ejaculate too low for IVF

Indications of ICSI with surgically extracted sperm (MESA / PESA / TESA / TESE)

• Congenital bilateral absence of the vas deferens (CBAVD)
• Obstructive azoospermia
• Non-obstructive azoospermia
• Anejaculation
• Retrograde ejaculation