Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is a form of micro-assisted fertilization where the nucleus (genetic material) of the sperm is injected directly into the egg.  It is used mostly in cases where the sperm have poor motility.  Below is a graphically enhanced photo of ICSI. 

ICSI is performed by a highly skilled embryologist and involves selecting a sperm, picking it up with a specialized micro-needle and injecting it directly into the egg.  You can think of it as the laboratory equivalent of a "pre-arranged marriage."  This process guarantees placement of the sperm DNA within the egg, though it does not guarantee successful fertilization, as there may be underlying genetic problems with either the sperm or the egg.  

Conventional IVF does not usually use ICSI.  In a conventional IVF cycle where the sperm is allowed to naturally fertilize the egg, in rare instances zero or very few eggs will fertilize due to eggs having tough thick zona (shells) or underlying sperm problems. If this occurs, it is usually a good idea to try another IVF cycle and use ICSI. At Red Rock Fertility Center, we occasionally encourage patients with normal semen analyses to do half ICSI/half conventional IVF in order to reduce the number of cases of poor fertilization. 

ICSI is an effective procedure in assisting fertilization for couples with sperm problems, and has been in widespread use around the world since the early 1990's.  There are approximately 150,000 IVF cycles done each year in the US and about half of them use ICSI to achieve fertilization.