Intracytoplasmic Sperm Injection (ICSI)

Difficulties with sperm quality or function contribute to fertility problems in approximately half of couples trying to conceive. Intracytoplasmic Sperm Injection (ICSI) is an advanced form of IVF designed to help overcome male factor infertility and improve the chances of successful fertilisation. Using highly specialised micromanipulation techniques, our skilled embryologists carefully select and inject a single sperm directly into an egg within our state-of-the-art laboratory.

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Intracytoplasmic Sperm Injection (ICSI)

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What is ICSI, and How Does it Work?

Intracytoplasmic sperm injection, or ICSI, is a specialised form of IVF in which a single sperm is carefully selected and injected into an egg to assist fertilisation. Unlike conventional IVF, where eggs and sperm are placed within the same culture dish, ICSI helps to overcome situations where sperm may be unable to fertilise the egg naturally.

The remaining stages of treatment then follow the same steps as a standard IVF cycle.

ICSI is most commonly recommended where there is a diagnosis of male factor infertility, a history of failed or poor fertilisation in a previous IVF cycle, or where surgically retrieved sperm is being used. It may also be advised if only a small number of eggs are collected.

At Genus Fertility, every ICSI cycle is planned around your individual results, with our embryology team working alongside your consultant to give your treatment the best possible foundation.

How Do I Know if I Need ICSI?

ICSI is most commonly recommended when sperm quality or function affects the ability to conceive naturally, and might also reduce the likelihood of successful fertilisation with conventional IVF. ICSI may be recommended if:

You have a low sperm count or number
Sperm shape (morphology) is significantly abnormal
Sperm movement (motility) is reduced, and the ability of sperm to swim effectively
You have experienced failed attempts at fertilisation through conventional IVF
Surgical sperm retrieval is required
You have obstructive azoospermia, where a blockage in the male reproductive tract prevents sperm from being released naturally

The ICSI Process Step by Step

Sperm collection and selection:
A sperm sample is usually provided on the day of egg collection, although in some situations, surgically removed or previously frozen sperm may be used. Our embryologist carefully prepares and assesses the samples before selecting the most suitable sperm for injection.
Ovarian stimulation:
The aim of the stimulation phase is to encourage the ovaries to grow multiple follicles containing mature eggs. During this stage, medications are also used to temporarily suppress the body’s natural hormone signals and prevent premature ovulation before egg collection. You will take hormone injections at home for around 9 to 14 days. Throughout treatment, your response is carefully monitored using an internal ultrasound scan every few days as clinically indicated. This allows us to personalise medication doses and accurately time the next stages of treatment.
Trigger injection:
Once the follicles have reached the appropriate stage of development, you will be advised to take a carefully timed “trigger injection”. This injection helps the eggs complete their final stage of maturation prior to collection. The timing of the trigger injection is extremely important, as egg collection is usually performed approximately 34 to 36 hours later. Our team will provide clear instructions regarding the exact timing and administration of the medication.
Egg collection:
Once the follicles have reached an appropriate stage of development, the eggs are collected via a straightforward, minor surgical procedure performed under deep sedation. Using ultrasound guidance, a fine needle is passed through the vaginal wall into the ovaries to collect the fluid from the developed follicles. The procedure takes around 20 to 30 minutes. After collection, the eggs are transferred to our team of embryologists in our state-of-the-art lab, where they are identified, assessed and prepared for fertilisation.
Embryo development:
The eggs are fertilised in the laboratory with sperm from your partner or a donor. In conventional IVF, eggs and prepared sperm are combined within a specialised culture dish. In some cases, we may recommend Intracytoplasmic Sperm Injection (ICSI), where a single sperm is carefully injected into the egg. The embryos are kept within carefully controlled time-lapse incubators, allowing continuous assessment of the development while maintaining a stable laboratory environment. Our embryology team monitors embryo development over the next five to six days to help identify embryos with the highest developmental potential.
Embryo transfer:
Before your egg collection, we will discuss the most appropriate embryo transfer strategy for you, including whether you’re planning a fresh or frozen transfer. Embryo transfer is a quick, straightforward procedure for placing an embryo into the uterus. Following the transfer, there is typically a two-week wait before taking a pregnancy test.

FAQs

How is ICSI different from IVF?

ICSI and IVF follow almost identical processes until the fertilisation stage. In IVF, eggs and sperm are placed together in a specialised culture dish in the laboratory, allowing the sperm to fertilise the eggs naturally. In ICSI, a single sperm is carefully selected and injected directly into each mature egg by a skilled embryologist using specialised microscopic equipment.

Is ICSI more successful than IVF?

ICSI can improve fertilisation rates in situations where sperm quality or function may reduce the likelihood of successful fertilisation with IVF, such as low sperm count, reduced motility, or abnormal shape. Overall pregnancy and live birth rates also depend on many other factors, including egg quantity and quality, maternal age, embryo development and underlying causes of infertility.

What are the risks of ICSI?

ICSI is generally considered a safe and well-established procedure, although it involves additional considerations compared with IVF. These include a small risk of damage to eggs during the injection process and the possibility that certain causes of male infertility may have a genetic component that could potentially be passed on to male offspring.

There may also be a slightly increased risk of miscarriage because the technique uses sperm that would not otherwise have been able to fertilise an egg. We will discuss the potential benefits, limitations, and risks of the treatment with you before proceeding, so you can make a fully informed choice.

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic Sperm Injection (ICSI)

What is ICSI, and How Does it Work?

How Do I Know if I Need ICSI?

The ICSI Process Step by Step

Sperm collection and selection:

Ovarian stimulation:

Trigger injection:

Egg collection:

Embryo development:

Embryo transfer:

FAQs

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