Intracytoplasmic Sperm Injection (ICSI)

Fertility is a complex process, and several stages must occur correctly for a successful pregnancy to develop. One of the most important stages is the fertilization of the egg by the sperm. In some cases, even when both eggs and sperm are available, fertilization may not occur naturally or may remain limited during conventional IVF.

In such situations, Intracytoplasmic Sperm Injection (ICSI) may help increase the chance of fertilization and embryo formation.

During ICSI, an embryologist uses highly precise laboratory equipment to select a suitable sperm and inject it directly into a mature egg. ICSI is one of the major advances in fertility treatment and is now used not only for male-factor infertility, but also in several other medical situations where improving the chance of fertilization may be beneficial.

At Taban Fertility Center, the decision to use ICSI is based on each couple’s individual circumstances, egg and sperm quality, previous treatment history, and the assessment of the medical and embryology teams.

How does ICSI help treat infertility?

In conventional IVF, eggs and sperm are placed together in the laboratory so that fertilization can occur without direct injection.

With ICSI, this stage is performed more precisely. A selected sperm is injected directly into a mature egg.

After injection, the eggs are kept under carefully controlled laboratory conditions. During the following hours and days, embryologists assess whether fertilization has occurred and monitor embryo development.

If suitable embryos develop, they may be transferred into the uterus or frozen for future use according to the treatment plan.

When may ICSI be an appropriate treatment option?

ICSI is not necessary for every couple undergoing IVF. The physician and embryology team decide whether it may improve the chance of fertilization based on the cause of infertility, test results, sperm and egg quality, and previous treatment outcomes.

ICSI may be considered in the following situations:

Male-factor infertility

A low sperm count, reduced sperm motility, abnormal sperm shape, or poor sperm quality are among the most common reasons for using ICSI.

In these situations, selecting a suitable sperm and injecting it directly into the egg may increase the chance of fertilization.

Previous poor or failed fertilization during IVF

In some cases, fertilization may be limited or may not occur during a previous conventional IVF cycle, even when egg and sperm quality appear acceptable.

In such situations, ICSI may be recommended in a future treatment cycle.

Use of surgically retrieved sperm

When sperm are obtained through procedures such as TESE or other sperm retrieval techniques, ICSI is usually the preferred method of fertilization.

Use of previously frozen eggs

After frozen eggs are thawed, fertilization is often performed using ICSI to improve the opportunity for embryo formation.

Selected treatment circumstances

ICSI may also be recommended when only a limited number of mature eggs are available or when the treatment team believes that conventional fertilization may have a lower chance of success.

How is ICSI performed?

After egg retrieval, mature eggs are prepared in the embryology laboratory. At the same time, the semen sample is assessed, and suitable sperm are selected based on movement and laboratory characteristics.

Using advanced micromanipulation equipment, the embryologist gently holds the egg in a stable position. A single selected sperm is then injected into the egg using a very fine needle.

This procedure is performed with a high level of precision to minimize possible damage to the egg.

After injection, the eggs are placed in specialized incubators. Fertilization and embryo development are then monitored carefully over the following days.

Why is the embryologist’s precision important in ICSI?

ICSI is one of the most sensitive laboratory procedures in fertility treatment, and its quality depends on more than advanced equipment alone.

Selecting an appropriate sperm, identifying mature eggs, performing the injection correctly, and evaluating fertilization all require experience, technical skill, and close attention from the embryology team.

At Taban Fertility Center, all stages of ICSI are carried out using specialized laboratory equipment and careful embryology assessment so that every mature egg is evaluated individually and prepared for fertilization with precision.

Do underlying medical conditions or medications matter?

Yes. Conditions such as diabetes, high blood pressure, thyroid disorders, autoimmune diseases, kidney disease, or a history of cancer treatment do not always prevent ICSI. However, they may affect treatment planning, medication selection, or the timing of treatment.

The physician should also be informed about all medications, supplements, and herbal products used by both partners.

No medication should be stopped or changed without medical advice.

Does ICSI guarantee successful treatment?

No. ICSI may increase the chance of fertilization, but it does not guarantee embryo development or pregnancy.

The final outcome also depends on several other factors, including:

Egg quality and maturity

Sperm health

Embryo development

Uterine condition

The woman’s age

The underlying cause of infertility

Previous treatment history

For this reason, ICSI is recommended only when the treatment team believes it may provide a meaningful benefit for that couple.

Important Information

ICSI is not used only for male-factor infertility

Although ICSI was originally developed to help treat male-factor infertility, it is now also used in several other situations where increasing the chance of fertilization may be beneficial.

Injecting a sperm into an egg does not mean selecting the baby’s sex

ICSI is a fertilization technique and does not, by itself, determine the sex of the embryo. If there is a medical reason to assess sex chromosomes or certain genetic conditions, additional methods such as Preimplantation Genetic Testing (PGT) may be considered.

ICSI does not increase the chance of twins

The main factor affecting the chance of a multiple pregnancy is the number of embryos transferred into the uterus, not the method used for fertilization.