ICSI Treatment and Procedure

Intracytoplasmic Sperm Injection or ICSI is a technique that can be used to treat certain kinds of male infertility that can’t be overcome with IVF alone. The procedure assists fertilisation by injecting the sperm directly into the egg. ICSI enables embryos to be produced even when sperm isn’t able to fertilise the eggs by itself. The embryos can then be transferred into the womb.

What is ICSI?

ICSI is a treatment for male infertility that can be used during IVF to help the sperm to fertilise the eggs. The ICSI procedure happens after the sperm and eggs have been collected. It can help to create embryos that can then be transferred into the womb.

The term Intracytoplasmic Sperm Injection describes how the procedure is performed. It means that individual sperm cells will be injected directly into the cytoplasm or inside of an egg cell. The procedure mimics what happens when a healthy sperm cell encounters an egg, but it enables fertilisation to happen even if the sperm isn’t able to reach or enter the egg cell by itself.

Who Might Be Recommended to Have ICSI?

The ICSI procedure is designed for couples who have specific kinds of fertility problems. It may work for you even if conventional IVF hasn’t been able to produce viable embryos.

Sperm-related fertility problems affect approximately half of all couples who are having trouble conceiving naturally. In some cases, these issues can be overcome with conventional IVF treatment. However, in some cases additional help is required to ensure that fertilisation happens.

The ICSI procedure is recommended when there are issues that prevent the sperm from fertilising the egg, even when they are brought together in vitro. It might be suitable if you have a very low sperm count, poor motility, or your sperm is abnormally shaped. The ICSI procedure may also be able to help if there are issues with the quality of frozen sperm or if your sperm has to be collected surgically from the testes.

When you begin considering fertility treatment, you and your partner should both have full fertility assessments to try to identify the reasons for your problems conceiving. Semen analysis will determine whether there are any issues with the sperm quantity or quality that might need to be treated with ICSI. Your fertility specialist will recommend the treatment if it is needed to ensure that fertilisation will happen during IVF treatment.

ICSI may sometimes be recommended even if there isn’t a specific issue with the sperm quantity or quality. If you have tried IVF before and it only resulted in a few or no successful fertilisations then your doctor may recommend trying ICSI to increase the success rate. However, the ICSI procedure can only help with sperm-related fertility problems so it can’t increase the fertilisation rate if there are issues with the eggs.

ICSI may also be used if you are carrying a genetic condition and you want the embryos to undergo screening. The ICSI procedure can ensure that the screening results are more reliable by preventing any contamination from other sperm cells that might be on the outside of the fertilised egg.

How Does ICSI Treatment Work?

ICSI is a specialised technique that is used alongside the more conventional IVF procedure in order to overcome specific kinds of fertility problems. If you are having ICSI then you will go through all of the same stages of IVF, but the in vitro fertilisation will happen in a slightly different way. Instead of simply allowing the eggs and sperm to mix, we will intervene to bring them together. A single sperm cell will be injected directly into each egg. The resulting embryos can then be transferred into the womb when they are ready. The success rate for fertilisation by ICSI is very high, at approximately 90%. The success rates for implantation and later stages are then similar to conventional IVF.

The ICSI procedure mimics the behaviour of healthy sperm. Normally, the sperm cells should be able to detect the presence of an egg and swim towards it. When they reach the egg, sperm cells should burrow into the egg. Fertilisation happens when one of the sperm cells enters the egg and they fuse together to form a single cell that will become the embryo. If the sperm isn’t able to do all this by itself, then the ICSI procedure can ensure that a sperm cell is placed inside each egg.

In some cases, we may also need to collect the sperm in a different way. The male fertility problems that can prevent fertilisation from happening can also make it harder to get a good sperm sample. For example, your semen may not contain many sperm cells if they are unable to move well. We may be able to get a larger number of viable sperm if we extract them surgically from your testicles or epididymis (the tube where they are stored). Although surgical extraction may sound a bit scary, it’s a very simple procedure that is usually performed by using a fine needle to collect the sperm. You won’t usually feel anything as you’ll be given a local anaesthetic. The sperm can then be injected into the egg using the ICSI procedure.

How Safe is ICSI?

The risks associated with the ICSI procedure are slightly higher than for the normal IVF procedure. It is therefore only recommended when it is necessary to produce fertilised eggs. If there aren’t any issues with the sperm quantity or quality then it is usually best to rely on conventional IVF without the ICSI procedure.

The additional risks for ICSI relate to the way the eggs are manipulated in order to perform the procedure. The eggs need to be cleaned and then injected with single sperm cells. There is a chance that the eggs can be damaged during this process, which might cause problems later on for the embryo or the child who is born. You will need to discuss the safety of ICSI in detail with your fertility specialist in order to decide whether the procedure is right for you. Although there are some additional risks involved, the evidence on the long term consequences of ICSI is still unclear and the risks are believed to be relatively low.

Risks Involved

The ICSI procedure is performed during IVF treatment, so it comes with all of the same risks as the usual procedure. However, there are a couple of additional issues associated with ICSI that you will need to consider.

Firstly, there is a chance that the egg could be damaged while it is prepared for the procedure or as the sperm cell is injected into it. The impact of this is not fully understood, but there is a chance that it could result in long-term health problems. There might be a slightly increased risk of certain genetic or developmental disorders in children who have been born using this procedure. However, it is still unclear whether this is due to the ICSI procedure or something else and the number of children who are affected is very small.

Secondly, there is a chance that any sons who are born with the ICSI procedure may inherit their father’s infertility if it is genetic. Since ICSI is a relatively new procedure, we don’t yet know what the impact might be on the fertility of boys who were conceived in this way. This is an issue that you might want to discuss with your fertility specialist before you begin treatment.

How We Can Help?

Our experienced fertility doctors can arrange tests to check for the kinds of male fertility problems that ICSI may help to overcome. We can also provide personalised advice on the best approach to fertility treatment for you. If you need to have ICSI as part of your IVF treatment then we can arrange all of your care either in London or overseas. We can arrange the ICSI procedure as part of IVF abroad in Dubai, Bahrain or Greece.

Don’t hesitate to get in touch if you want to learn more about ICSI. Our fertility specialists can advise you on whether ICSI is right for you and arrange IVF treatment using this procedure in the UK or overseas.


ICSI is an additional procedure that can be added-on to the normal IVF treatment. It takes places in the lab when the egg and sperm are brought together. Instead of letting the sperm mix with the eggs so that they can be fertilised, individual sperm cells will be injected directly into each egg. The procedure can increase the chances of fertilisation happening when there are issues with the quantity or quality of the sperm.

The ICSI procedure is usually recommended to tackle male fertility problems. Your doctor might suggest using ICSI if you have a very low sperm count, poor motility or a large proportion of abnormal sperm. You will find out if you have any of these issues when you have a semen analysis as part of the male fertility assessment that is performed at the beginning of the treatment. Your fertility specialist will help you to decide whether the ICSI technique is right for you.

The ICSI procedure isn’t recommended when there isn’t a specific need to have it. Although ICSI can increase the chances of fertilisation happening when there are sperm-related fertility problems, there is a chance that it could damage the eggs. Some evidence suggests that there could be an increased risk of certain developmental disorders in children born using this technique. It is therefore best to rely on the conventional IVF procedure unless you need to have ICSI to overcome male infertility.

ICSI can increase the chances of fertilisation when you are affected by certain types of male infertility, but it won’t always result in successful fertilisation or pregnancy. It is possible that the procedure won’t result in any viable embryos that can be transferred to the womb. Even if the ICSI procedure does work, the success rate for IVF using embryos produced by ICSI is about the same as for conventional IVF. If the ICSI procedure doesn’t work, you will need to discuss the options with your fertility specialist. The doctor might recommend trying another cycle of IVF with ICSI if there is still a good chance of success. However, you might also want to consider using a sperm donor if it wasn’t possible to create embryos using the ICSI procedure and your own sperm.

The ICSI procedure can overcome male fertility problems that prevent the sperm from reaching or entering the egg. If you have these kinds of issues then the procedure could be beneficial for you. However, it won’t help with other kinds of infertility. For example, if there are issues with the quality of the eggs then using ICSI won’t increase the chances of successful fertilisation. If you have other fertility problems alongside sperm-related infertility then the ICSI procedure may not be successful.

The ICSI procedure can be used with sperm that has been produced by ejaculation, but it can also help if the sperm has to be collected directly from the testes. Sometimes it is necessary to collect sperm surgically in order to maximise the chances of success for IVF. This is usually because the number or quality of the sperm in the semen is very low. The procedure uses a fine needle to extract the sperm from the testicle or from the epididymis tubes where they are stored. In some cases, a sample of tissue may need to be taken from the testicle so that sperm cells can be extracted in the lab. The individual sperm cells can then be injected into eggs using the ICSI procedure.

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