Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is a form of micro-assisted fertilization. In vitro fertilization (IVF) without ICSI involves mixing thousands of motile sperm with each egg in a Petri dish. We call this insemination of the eggs. The sperm and eggs must join their DNA. The hoped-for result is conventional fertilization of most of the eggs.

However, in some cases, either egg or sperm factors are deficient and very few (or none) of the eggs become fertilized after overnight incubation with sperm. Sperm may need to have assistance with fertilization. This is done by Intracytoplasmic sperm injection (ICSI) .

ICSI involves:

  • Selecting a sperm
  • Picking it up with a specialized micro-needle
  • Injecting it into the middle of the egg so that the sperm DNA can join with the egg DNA (fertilization)

Advanced Fertility embryologists have extensive experience with ICSI and achieve high fertilization rates. The procedure allows men with little, or sometimes no, sperm in their ejaculate to create genetically related children.


  • After egg retrieval, the oocytes (eggs) are separated from the follicular fluid and placed in a Petri dish.
  • Approximately 1 hour later, the granulosa cells are stripped away from the egg. The eggs are examined under a microscope to assess maturity
  • On all the mature eggs, a small hole is made in the zona pellucida (egg membrane) using microscopic tools and the sperm is inserted directly into the egg.
  • After insertion of the sperm (ICSI), the embryos are placed in incubators until ready for transfer.

ICSI combined with MESA is a noninvasive method of sperm recovery

It has excellent potential for men who have had a vasectomy and do not wish to undergo surgical reversal, or had a failed surgical reversal. The success rates per cycle can exceed those for a vasectomy reversal.

ICSI combined with MESA requires that a small needle be placed into the epididymis, using local anesthesia, to withdraw the sperm. The epididymis normally serves as a reservoir for sperm.