Intracytoplasmic sperm injection (ICSI) is an assisted reproductive technology (ART) used to treat sperm-related infertility problems. ICSI is used to enhance the fertilization phase of IVF by injecting a single sperm into a mature egg. The fertilized egg is then placed in a woman's uterus.

Sperm collection. If sperm cannot be collected by means of masturbation, they are surgically removed from a testicle through a small incision. This method of sperm retrieval is done when there is a blockage that prevents sperm from being ejaculated or when there is a problem with sperm development. To screen for possible genetic problems that could affect offspring, it is recommended that men with little or no sperm in their semen (not due to a blockage) have genetic testing before they proceed with ICSI.

Sperm injection and transfer. Under high-power magnification, a glass tool (holding pipet) is used to hold an egg in place. A microscopic glass tube containing sperm (injection pipet) is used to penetrate and deposit one sperm into the egg. After culturing in the laboratory overnight, eggs are checked for evidence of fertilization. After incubation, the eggs that have been successfully fertilized (zygotes) or have had 2 to 5 days to further develop (zygotes or blastocysts) are selected. One or 2 are placed in the uterus using a thin flexible tube (catheter) that is inserted through the cervix. The remaining embryos may be frozen (cryopreserved) for future attempts.

Why is it Done
Intracytoplasmic sperm injection (ICSI) is used to treat severe male infertility, as when little or no sperm are ejaculated in the semen. Immature sperm collected from the testicles are usually unable to move about and are more likely to fertilize an egg through ICSI.
Some couples choose to try ICSI after repeat in vitro fertilization has been unsuccessful. In Turkey, almost all IVF procedures are currently performed using ICSI technology.
ICSI is also used for couples who are planning to have genetic testing of the embryo to check for certain genetic disorders. ICSI uses only one sperm for each egg, so there is no chance the genetic test can be contaminated by other sperm.

How successfull is it?
ICSI often is a successful treatment for men with impaired or no sperm in the ejaculate. ICSI (using sperm collected from the testicles) produces an estimated 45% to 50% pregnancy rate. ICSI does not improve the chances of conception for men with good-quality sperm in the ejaculate.