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Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is a fertilisation method used alongside an IVF treatment. It is effective at improving the chances of conception for those who suffer from male factor infertility, low sperm motility, low sperm count, or sperm morphology. Here we explain what ICSI is, who might need it and how it’s performed.

Image shows intracytoplasmic sperm injection (ICSI) being performed as a sperm cell in injected into an ovum (egg) to treat male factor infertility
Sperm cell being injected into an egg during intracytoplasmic sperm injection (ICSI)

What is intracytoplasmic sperm injection? 

ICSI was introduced in clinical practice to help overcome male factor infertility issues1. With ICSI, only a small number of sperm are required. Embryologists use specialist equipment to inject sperm individually into each egg under a microscope with high magnification2.

When is intracytoplasmic sperm injection most suitable? 

Your doctor will discuss if ICSI is a suitable fertilisation method for your treatment. Indications for ICSI may include low sperm count (how many sperm there are), low sperm motility (how they move), low sperm morphology (how they look) and previous failed fertilisation with IVF3. You can read more about semen analysis here.

How is intracytoplasmic sperm injection performed?

ICSI is a fertilisation method used to fertilise eggs during IVF. After egg collection, the eggs would first be assessed for maturity, as only mature eggs may be injected. Sperm would be selected under a high magnification and injected directly into the egg with a small needle.

Are there any risks? 

Risks with ICSI include increased risk to the eggs when they’re cleaned to assess maturity and injected with the sperm. It has been suggested that there is a potential increased risk in long term health conditions to children born following this procedure, however the research is not conclusive1.

While the above risks are small, it’s important to know that they exist and the doctor at your clinic should explain what the chances may be for you during your treatment. 

How effective is it?

Intracytoplasmic sperm injection can increase fertilisation rates compared to IVF, but the chances of falling pregnant are similar3. The most recent data from the HFEA shows that the percentage of live births following IVF and ICSI treatment was4:

  • 32% for women under 35
  • 25% for women aged 35 to 37
  • 19% for women aged 38 to 39
  • 11% for women aged 40 to 42
  • 5% for women aged 43 to 44
  • 4% for women aged over 44

You fertility clinic will be able to discuss with you whether ICSI is the right option for you.

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