ICSI is used to help male factor of fertility. The steps leading to ICSI are identical to IVF until the eggs are retrieved. Instead of mixing the sperm and eggs in a dish and waiting for fertilization, individual eggs are isolated and, with the use of sophisticated micromanipulation techniques, a single sperm is injected into each egg. The fertilized eggs are then incubated as in IVF until they are ready for transfer.

Common reasons used for performing ICSI:

• Recurrent pyospermia
• Collection of sperm from the testes
• Frozen-thawed sperm
• Small number of retrieved eggs
• Use of cryothawed oocytes
• Oocytes considered for preimplantation genetic diagnosis (PGD)
• When an embryo is needed for gene defected analysis
• Advanced age
• Ejaculatory dysfunction
• Retrograde ejaculation
• Failed fertilization by regular IVF
• Unexplained infertility
• Immunological infertility

What does the treatment involve?

Eggs and sperm are collected in the same way as in a normal IVF treatment. However, unlike conventional IVF a single sperm is picked up from a prepared sperm sample in a very fine glass needle and injected through the zona pellucida and the egg membrane directly into the centre of the egg. In this way, the sperm is not required to penetrate any of the surrounding barriers. The injected eggs are then incubated for sixteen hours and checked to see if fertilization has occurred. If fertilization does occur, up to two embryos are replaced two days after the egg collection as in a normal IVF treatment or after 4-5 days if blastocyst culture and transfer is recommended.