What is Intracytoplasmic Sperm Injection (ICSI)? Process and Risk

Intracytoplasmic Sperm Injection (ICSI)

Intracytoplasmic sperm injection (ICSI) is an infertility treatment for infertile couples and a ray of hope for pregnancy in infertile couples. This process is particularly beneficial when couples face infertility issues due to male infertility problems. In the ICSI procedure to encourage conception, your healthcare professional injects sperm into your egg procedure & pregnancy is possible following embryo transfer. Let us understand the process in detail. 

Understanding Intracytoplasmic Sperm Injection

The ICSI is an approach to help conceive couples dealing with infertility. The intracytoplasmic sperm injection (ICSI) is a therapy for infertility. It includes injecting the woman’s eggs with live sperm with the help of injection in a lab. Thus, fertilizing the women’s egg and producing an embryo. ICSI is an in vitro fertilization technique (IVF). If male infertility impacts a woman’s capacity to conceive, ICSI is most often used by fertility experts.

Also Read: IVF ICSI Procedure – Important Things You Need to Know

Why Should One Consider ICSI?

Before a man’s sperm fertilizes a woman’s egg, the sperm’s head should adhere to the egg’s exterior. Once adhered, the sperm penetrates the egg’s outer surface to reach the cytoplasm or egg’s interior, where fertilization occurs.

For several reasons, the sperm occasionally cannot permeate the outer surface. Either there are some motility issues with the sperm, or the egg’s exterior surface might be difficult or thick to penetrate. So in this situation, the doctor may recommend an ICSI procedure.

Some other reasons when the doctor may ask to undergo the ICSI procedure include:

  • The male produces insufficient sperm for artificial insemination (intrauterine insemination [IUI]) or in vitro fertilization (IVF).
  • Sperm may not swim in a typical manner or sperm motility.
  • It may be difficult for the sperm to connect to the egg.
  • An obstruction in the male reproductive system may prevent the release of sperm.
  • Traditional IVF fails to fertilize eggs, regardless of the quality of the sperm.
  • Azoospermia
  • Using previously frozen eggs

Intracytoplasmic Sperm Injection Procedure

Intracytoplasmic Sperm Injection Procedure

IVF allows for both traditional and ICSI fertilization of an egg. The egg is put close to 50,000 or even more live sperm in the laboratory dish during traditional IVF. When a sperm penetrates the egg cytoplasm, fertilization takes place. During the ICSI procedure, only one sperm is injected into the egg’s center using a small needle known as a micropipette. After fertilization, whether via standard ICS or IVF, the fertilized egg or embryo develops in a lab for one to five days before being implanted into the woman’s uterus (womb).

What Happens Before The ICSI Procedure?

Before starting the ICSI procedure, the doctor will collect the eggs and sperm. 

Here are the steps for egg retrieval:

  • Ovulation induction: The egg donor gets medicine injections for eight to fourteen days to induce ovulation. So this promotes the ovaries to develop several eggs concurrently. The woman receives a Lupron injection or human chorionic gonadotropin, which assists in the eggs’ ultimate maturation.
  • Egg retrieval: The doctor utilizes transvaginal ultrasound equipment to extract eggs from the ovaries. 

If there is no use of frozen sperm, sperm retrieval will occur on the egg retrieval day. The individual who gives sperm:

  • Two to three days before sperm retrieval, avoid intercourse and masturbation (no ejaculating).
  • The individual performs masturbation at home or in the fertility center’s room and collects the release in a container offered by the laboratory. Under 60 minutes of ejaculation, the lab must receive the sample. 

The lab then performs immediate sperm analysis to evaluate the quantity, motility, and sperm quality. Further, individuals with anejaculation, or retrograde ejaculation, azoospermia, may need a sperm collecting technique.

What Happens Following The ICSI Process?

Your fertility expert examines the fertilized egg for indications of fertilization in the lab after ICSI. A properly fertilized egg will divide into cells and become a blastocyst between five to six days. Further, your healthcare professional will examine the cell mass and the blastocyst size to decide when it is most probable to lead to pregnancy.

Embryo transfer typically happens on the fifth or sixth day after the egg retrieval procedure. The doctor will inform the timings of the embryo transfer. Using ultrasound equipment, your doctor will place a catheter into your vagina and implant the embryo inside your uterus. The embryo must implant (connect) to your womb for pregnancy to occur. Your doctor may advise getting the pregnancy test after two weeks.

Intracytoplasmic Sperm Injection Benefits 

The major benefit of the ICSI procedure is that it helps those couples experiencing male infertility. So it may successfully enhance the fertilization rate. 

Intracytoplasmic Sperm Injection Success Rate 

At Aastha Fertility, several couples with challenging male factor infertility issues have succeeded in becoming pregnant with the ICSI treatment. ICSI and traditional IVF have the same success rates for conceiving a child. According to estimates, 50 to 80 percent of ICSI procedures result in fertilization.

Can ICSI Impact A Baby’s Growth?

A 1.5 percent to 3 percent possibility is there that a woman who becomes pregnant naturally would give birth to a child with a major congenital disability. Yet, the risk of congenital disabilities related to ICSI is comparable to that of IVF.

It’s possible that infertility itself, rather than the medications used to cure it, is to blame for the slightly increased risk of birth abnormalities.

A few diseases, including Angelman syndrome, Beckwith-Wiedemann syndrome, hypospadias, and sex chromosomal abnormalities, have been linked to using ICSI. They might be present in fewer than 1% of infants born through this method.

Infertility might be due to issues that have hereditary origins. For instance, male infants born with ICSI may experience similar infertility problems as their biological fathers.

Intracytoplasmic Sperm Injection Vs. IVF

Intracytoplasmic Sperm Injection Vs. IVF

How sperm fertilizes the egg is the primary difference between IVF and ICSI. In IVF, the egg and sperm are introduced into a laboratory dish to fertilize themselves. However, in ICSI, the doctor directly injects the sperm directly into the egg.

The Cost Of Intracytoplasmic Sperm Injection

As the ICSI procedure is a technical process, only skilled IVF experts perform the procedure, which may increase the cost of IVF. ICSI is a technique that involves numerous cycles, and each cycle incurs additional fees and must be paid for separately. The minimal ICSI cost for each cycle in India is between Rs. 2,40,000 and Rs. 2,50,000.

Does ICSI Increase The Likelihood Of Having Multiple Children?

To boost the likelihood of a successful pregnancy, the doctor may fertilize numerous eggs using ICSI. If you transfer multiple embryos, you may end up with twins, triplets, or more. Multiple pregnancies may raise the risk of preterm delivery and other issues for the mother and the unborn children.


In case couples face difficulty in conceiving, your doctor may suggest intracytoplasmic sperm injection (ICSI). This method of in vitro fertilization (IVF) is particularly useful in cases of male infertility. The procedure involves multiple steps. If you are still confused about the procedure or need more information about the process, Aastha Fertility is here to help you.

Dr Namita Kotia

Dr Namita Kotia

Dr. Namita Kotia (IVF specialist in Jaipur) attained her Master’s in Obstetrics and Gynecology from S.N. Medical College, Jodhpur affiliated to University of Rajasthan in 1997. She has more than 10 years experience in field of Assisted Reproductive Technology (ART).Presently at Aastha Fertility Care Dr. Namita along with her team is providing complete infertility work up and treatment options under one roof. Her aim is to provide proper guidance and treatment to Infertile couples at AFFORDABLE RATES.She is life member of Indian Academy of Human Reproduction (IAHR), Indian Society for Assisted Reproduction (ISAR), Federation of Obstetrics and Gynecology Society of India (FOGSI) and Jaipur Obstetrics Gynecology Society (JOGS). She has a number of publications in various journals and presentations at state and National level conferences to her credit.Dr. Namita is also recipient of best paper presentation viz “Diagnosis of Congenital Mullerian anomalies by three dimensional Transvaginal Sonography” awarded at “Kishori” Conference in Jodhpur (2000).

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