More about ICSI

Overview of ICSI

ICSI or intracytoplasmic sperm injection is a specialized version of IVF (in vitro fertilization), which is mostly used in cases where the fertilization through conventional IVF has failed multiple times, after egg freezing, or severe male infertility.

During regular IVF procedure, several sperm are put together with an egg with a hope that a sperm will enter and then fertilize the egg. In the case of ICSI, the doctor will take a single sperm and inject it directly into the egg.

Some fertility specialists recommend ICSI after every IVF cycle. While others may recommend the ICSI treatment in the cases with severe male infertility or other medically indicated reasons.

Why is ICSI Done?

Only during severe medical reasons, like male infertility, the ICSI procedure is used, including -

  • Asthenozoospermia or abnormally shaped sperm
  • Teratozoospermia or poor sperm movement
  • Oligospermia or very low sperm count
  • TESE or Testicular sperm extraction
  • Frozen sperm are used
  • Previous IVF cycle had very few or 0 fertilized eggs
  • Frozen oocytes are used
  • IVM is use, IVM or in vitro maturation is retrieval of eggs from ovaries before they mature completely.

ICSI Procedure

ICSI is performed as IVF’s part. Since ICSI process is conducted in lab, your IVF treatment would not seem different than the IVF treatment without ICSI. In this process, you will be taking ovarian stimulating drugs, and the fertility specialist will monitor your progress using ultrasounds and blood tests.

Once you have grown sufficient good-sized follicles, you will undergo egg retrieval, where the eggs are removed from the ovaries with a specialized needle guided by ultrasound. After the eggs are retrieved, the doctor will put the eggs in a culture and with the use of a tiny needle and a microscope, one sperm will be injected in the egg. This will be performed for each egg that is retrieved.

In case fertilization occurs and the embryo is healthy, it is transferred to the uterus via a catheter put through the cervix, 2-5 days after the egg retrieval.


The ICSI treatment costs between $1,400 and $2,000. Since it is conducted along with IVF, which alone costs $12,000-$15,000, the entire ICSI-IVF procedure may cost above $17,000 for a single session. So, ICSI can be more expensive than other infertility treatment options.

ICSI Risks

ICSI-IVF has all the risks that come with a regular IVF cycle. However, the ICSI procedure introduces additional ones. A regular pregnancy will have 1.5-3% risk of a major birth defect. In the case of ICSI treatment, the risks of birth defects if slightly more, although it is very rare.

Some birth defects that can happen with ICSI-IVF are Angelman syndrome, Beckwith-Wiedemann syndrome, sex chromosome abnormalities, and hypospadias. They happen in less than 1% of babies conceived via ICSI-IVF. So, your baby is more likely to be healthy and safe.

The ICSI success rate is 50-80%, which means there is 50-80% chance that the egg will fertilize. However, success rates vary for each couple depending on their underlying medical issue, age, and health.

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