Overview

ICSI is a specialised IVF technique in which a single sperm is selected and injected directly into a mature egg using a microscopic needle. Developed in 1992, ICSI revolutionised male infertility treatment and is now used in the majority of IVF cycles worldwide.

When Is ICSI Recommended?

• Severe oligospermia, asthenospermia, or teratospermia
• Azoospermia — sperm retrieved surgically (PESA, TESA, micro-TESE)
• High sperm DNA fragmentation
• Antisperm antibodies
• Previous failed or very low fertilisation with conventional IVF
• Use of frozen/thawed sperm with limited numbers
• PGT — to avoid biopsy contamination from extra sperm

Advanced ICSI Techniques

• IMSI — ultra-high magnification (6,600×) for selecting optimal sperm
• PICSI — selects sperm by hyaluronic acid binding; lower DNA fragmentation
• Testicular ICSI — testicular sperm often has lower DNA damage than ejaculated sperm

Success Rates

ICSI achieves fertilisation rates of 70–85% per mature egg injected. Overall pregnancy and live birth rates are comparable to conventional IVF for non-male-factor cases, and significantly better for male factor. Age of the woman and embryo quality remain the primary determinants.

Risks

• Same as standard IVF (OHSS, egg retrieval risks)
• ~5–10% of eggs may be damaged during injection
• Y-chromosome microdeletions are passed to all male offspring — genetic counselling recommended

Male factor infertility does not have to mean no baby. Book a consultation today