Intracytoplasmic (in-trah-sy-toh-PLAZ-mik) sperm injection (ICSI) is an infertility treatment in which one sperm is injected directly into an egg.

Intracytoplasmic sperm injection (ICSI) is performed as part of your in vitro fertilization (IVF) procedure. It is a process in which a single sperm is injected into the cytoplasm (center) of each egg by an embryologist (a specialist in egg fertilization). After the egg has been injected with the sperm, the embryologist will observe the egg over the next day or so. If fertilization occurs and the embryo matures properly, it will be transferred into your uterine cavity.

Your doctor may recommend ICSI as part of your IVF procedure to treat many causes of infertility, especially when there is a problem with the sperm such as low motility (movement) or a low sperm count. ICSI is especially useful in cases where the sperm cannot penetrate the egg or if the sperm are abnormally shaped.

How intracytoplasmic sperm injection is performed

Many eggs are needed for the ICSI process, so you will have to take fertility medications to induce ovulation during your cycle before the ICSI. Once your follicles (egg sacs) are mature, your eggs will be removed from your ovaries by a doctor. You may receive general anesthesia or intravenous sedation during this procedure. Meanwhile, your partner will be asked to provide a semen sample, which he will collect by masturbation at the doctor’s office. The sperm are evaluated and the healthiest sperm are selected for the ICSI procedure. After the eggs and sperm are collected, the ICSI process takes place in the lab. If the procedure is a success, your doctor will then discuss the number of embryos to be transferred to your uterine cavity. Usually several embryos are transferred to improve your chances for pregnancy. This procedure is relatively simple and takes only a few minutes. Your doctor will place a speculum inside your vagina, insert a small catheter through your cervix into your uterine cavity, and transfer the embryos through the catheter. Any discomfort from the transfer is minimal.

Questions & Answers

Q. How can ICSI help to improve my chances for pregnancy?
A. A single sperm is selected to be injected into the egg, and the embryo is transferred directly to your uterus. ICSI is a good option for patients in whom fertilization of the eggs is otherwise unlikely.

Q. Is there anything we need to do to prepare for this procedure?
A. You will need to take fertility medications during the treatment cycle procedure so that your ovaries will produce multiple eggs. Also, you should abstain from sex for 2 or 3 days before the egg retrieval to maximize semen quality. Check with your doctor to see if there are any other recommendations specific to you.

Q. How soon will we know if this treatment has been successful?
A. In general, a pregnancy blood test will be performed about 2 weeks after your embryo transfer. Do not do a home pregnancy test before that time—some of the fertility medications may cause false results if the test is performed too early.

Previous: In Vitro Fertilization Part 2—Egg Retrieval, Fertilization, and Transfer

Next: Intrauterine Insemination (IUI)