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What is ICSI (Intracytoplasmic Sperm Injection) Treatment?

  • 4.8 (7 Votes)

Intracytoplasmic Sperm Injection (ICSI) is a treatment used for male infertility in which single sperm is injected into the retrieved egg for fertilization. Special techniques are used to identify high-quality sperm. The chances of success for IVF are more when combined with ICSI.

Intracytoplasmic sperm injection (ICSI) is getting momentum with its high success rates all over the globe. Nowadays, ICSI has been seen getting used in nearly half of the IVF treatments done worldwide. ICSI is used for male infertility issues and improves the chances of conception. 

The best thing about ICSI is that it is a very clear-cut procedure. Under this procedure, only one sperm is used and injected directly into the ovum/egg. Here, utmost importance is given to find the best sperm so that it can successfully fertilize the egg. After fertilization, the fertilized egg or the embryo is transferred into the uterus with ART (Assisted Reproductive Technology) techniques.

When to go for ICSI?

One should opt for ICSI treatment after proper consultation and recommendation from doctor or medical professionals. Below are some of the situations under which you may be recommended to get ICSI done if you are looking for a baby-

  • Men with a very low sperm count.
  • If you have Poor Sperm Morphology (A high range of abnormally shaped and slow moving sperm).
  • Men with Retrograde Sperm Ejaculation issues. Under this situation men can’t ejaculate naturally through urethra and semen flows to the urinary bladder. With ART methods such as TESA, MESA, TESE etc. sperm is directly collected from the epididymis and ICSI is recommended mostly in such situations.
  • Men with Azoospermia (zero sperm in ejaculation) are also recommended ICSI.
  • Men with problems in erection and ejaculation due to various health issues.
  • After an IVF history with no or low rate of fertilization.

low rate of fertilization

  • Women with a low yield of eggs during egg retrieval.

What are the health concerns when planning for ICSI?

When you are considering ICSI, then you must keep in mind some of the important things related to procedure.

  • According to several studies, it is found that the pregnancies achieved via artificial insemination and particularly through IVF can result in having birth defects like imprinting defects.
  • Imprinting indicates a phenomenon where certain genes of baby functions differently. It depends whether it involves a particular chromosome passed to baby by the father or by the mother.
  • According to the reproductive researchers, it might affect the imprinting process or the subsequent release due to the manipulation of gametes or zygotes. While other researchers believe the incidence of birth defects keep occurring is similar to that of natural pregnancy thus, doesn’t create any obstacle in using such procedures.
  • It is advised to discuss with your reproductive specialist about the potential risks and complications involved in performing ICSI process.
  • While some people want to look for more traditional or over the counter methods before opting an infertility procedure. If you need assistance in the decision making process then you can connect with Largest Fertility Assistant Elawoman.

How to retrieve sperm for ICSI use?

  • The sperm is collected via normal ejaculation if man has low sperm count or low sperm motility.
  • If a man had the vasectomy done, then for restoring fertility the cost effective method is microsurgical vasectomy reversal.
  • The other alternatives are needle aspiration or microsurgical sperm retrieval i.e. MESA, TESA, if competent microsurgical vasectomy reversal procedure has failed.
  • In needle aspiration, the physician obtains required number of sperms for the ICSI process more easily and quickly. A tiny needle is used for sperm extraction directly from the testis.

Sperm extraction

This method is an easy and simple process, which is performed under sedation with minimum discomfort. But there is a possibility of pain and swelling once the procedure is done. The sperm collected from the testis is only suitable for the ICSI process.

What does ICSI procedure involve?

The ICSI procedure takes place during IVF procedure. Normally, it is performed for the couples who face severe male factor infertility and have a history of IVF failure.

The step-by-step procedure for ICSI discussed in detail are-

1- Ovarian stimulation- the ovaries of the woman are stimulated with medicines to help the growth of follicles. The response of the ovaries and final maturation of the eggs are monitored.

2- Retrieval of eggs- the mature eggs are retrieved within 35-38 hours under sedation.

3- Sperm selection- one healthy sperm with high motility is selected for insemination.

4- Assessment of eggs- the eggs are surrounded by cumulus cells which are removed through delicate enzyme so that they can be finally prepared for the insemination.

5- Insemination- this is the main step of ICSI where single sperm is injected into the matured egg.

6-  Verification- the eggs are tested next morning if they got fertilized or not.

7- Transfer of embryo- the embryo, which is chosen for transfer, is passed through the cervix into the uterus through transfer catheter. Normally one embryo is transplanted but in some cases transfer of more than one embryo can happen.

Transfer of embryo

8- Pregnancy test- Pregnancy blood test is done after 2 weeks of embryo transfer to see if the ICSI procedure has been successful or not.

How long does ICSI treatment take?

  • It usually takes about four weeks to six weeks for one cycle of ICSI to complete.
  • So, the couples must expect to spend half day at the clinic for both sperm as well as egg retrieval process.
  • Once the retrieval procedure is finished, you will be asked to visit the clinic after two to five days later for completing the embryo transfer process.

It is advised to the women who are under 40 years of age to opt for at least three cycles of IVF either with or without ICSI process.
And if you are between 40 to 42 year age group and never had IVF procedure done before then you will be offered one full IVF cycle after the discussion of risks and implications involved during pregnancy at this age.

What to expect after ICSI?

1- Normally, an ICSI session along with the shots, monitoring, and implantation becomes physically and emotionally challenging to many woman. Therefore, a proper care routine including a regular blood test and frequent monitoring are required after a session of ICSI.

However, the good thing is that one does not need to get hospitalized for a long period after ICSI.

2- The post care treatments can be done on outpatient basis.

Nonetheless, women after ICSI are advised to stay away from physically and mentally draining activities for at least a week or so as considered by your doctor.

What is the success rate of ICSI Treatment?

ICSI treatments are more successful than IVF treatment. It uses more advanced technology in which a high quality sperm is selected and injected into the egg for fertilization. Approximately 50% to 80% of the eggs are fertilized by ICSI process.

What are the Risks & Benefits of ICSI?

ICSI procedure for infertility treatment entails various benefits. However, it is not free of any potential risks. There are certain risks and benefits of ICSI which are discussed below:


  • ICSI is beneficial for those couples, who have failed IVF earlier.
  • It benefits the couples who desire pregnancy post-vasectomy.
  • ICSI is for those males who have lower sperm count and mobility.


  • Damage to embryos can happen during transfer
  • Multiple births can be a problem after ICSI
  • Gestational diabetes, low amniotic fluid levels and high blood pressure in the mother can also be seen as side effects of ICSI.

ICSI is an infertility treatment procedure, which involves the intracytoplasmic sperm injection in the mature egg. You can also read more about Treatments Used for Infertility Issues in Couples.

Dr. R K Sharma

About The Author

Reproductive Endocrinologist, Hysteroscopic Surgeon Dr. R K Sharma

Dr. R K Sharma has completed MBBS and MD in Obstetrics and Gynecology from Pune University in 1981 and 1989 respectively. Dr. R K Sharma is one of the pioneers in the field of IVF treatment in India. He specializes in IUI, IVF, Embryo transfer and Hysteroscopy procedures. He is also a member of Federation of Obstetrics and Gynecology Societies of India (FOGSI). Dr. R K Sharma is presently practicing at Primus Super Specialty Hospital, Chanakyapuri, Delhi. To know more, visit


  1. Treatment for male infertility male infertility, Elawoman - 2017
  2. Sperm facts - sperm count, how long sperm can live and much more sperm, Elawoman - 2017
  3. Reproduction and fertility basics fertilization, Elawoman - 2017
  4. Vitamins and minerals to help increase sperm count low sperm count, Elawoman - 2017
  5. Male infertility treatment with tesa TESA, Elawoman - 2017
  6. All you need to know about mesa MESA, Elawoman - 2017
  7. How to increase sperm count and improve fertility low sperm count, Elawoman - 2017
  8. How long does sperm live? sperm, Elawoman - 2017
  9. What is ivf (in- vitro fertilization)? IVF procedure, Elawoman - 2018



Biraj Gautam

My ICSI treatment was unsuccessful, should I go for the IMSI treatment?

Oct. 8, 2018, 4:28 p.m. 5.0


Garvith Singh

Very informative article for the couple who is looking forward to having ICSI treatment. Keep sharing.

Sept. 30, 2018, 9:56 a.m. 5.0


Shivani Bhutani

Thanks for sharing this information. Basically, ICSI treatment is the prime method to become fertile without any side effects.

June 14, 2018, 4:47 p.m. 5.0


Rahul Taneja

From where can I get information on ICSI treatment along with ICSI cost? My doctor has diagnosed me with low sperm count and I need to get this done.

June 2, 2018, 4:18 p.m. 5.0


Kundan Kattar

Is there any natural method to increase the sperm count? How can I keep a track upon my sperm count? Please suggest!

May 12, 2018, 10:25 p.m. 4.5


Deepak Kumar

My sperm count is 30 million per ml, should I have any ICSI treatment or I am fertile?

April 19, 2018, 5:23 p.m. 4.5


Sandeep Naik

I am impressed with the detailed information of ICSI treatment. The pictures in the blog are self-explanatory.

March 24, 2018, 8:24 p.m. 4.5

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