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Intracytoplasmic sperm injection (ICSI)

Intracytoplasmic sperm injection (ICSI)

Intracytoplasmic sperm injection (ICSI) refers to the insertion of sperm directly into an egg using a needle. This procedure is sometimes used during in vitro fertilization (IVF) in place of the traditional method of allowing the sperm to penetrate eggs on their own.
Indications

ICSI is most commonly used when male infertility is a known barrier to achieving fertilization. Male infertility may be attributed to low sperm count, abnormal sperm morphology and/or motility, decreased ability of sperm to attach to eggs, or an obstructed reproductive tract preventing sperm from being released.

ICSI is also used when fertilization attempts fail using the traditional IVF insemination method even if there are no identified male fertility issues.

Cryopreserved eggs to be used for IVF are often fertilized using ICSI, because the freezing process may decrease the ability of these eggs to be fertilized by conventional insemination methods.


Risks

ICSI may cause damage to some eggs.

This procedure has also been associated with a slight increase in birth defects compared to IVF without ICSI.  It is unknown whether this finding is a result of ICSI itself or a result of ICSI often being performed using sperm from males with abnormal semen.  Such semen samples are more likely to contain sperm with chromosomal abnormalities.  The likelihood of birth defects in babies resulting from IVF using ICSI is very low but couples should discuss any concerns with their physicians.


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References & Sources

Davies MJ, Moore VM, Willson KJ, Van Essen P, Priest K, Scott H, Haan EA, Chan A (2012) Reproductive technologies and the risk of birth defects. N Engl J Med 366:1803-13.
Intracytoplasmic sperm injection (ICSI) for non-male factor infertility:  a committee opinion (2012) Practice Committees of American Society for Reproductive Medicine, Society for Assisted Reproductive Technology. Fertil Steril 98:1395-9.

Other Contributors: Brittany L. Coughlin, M.A.

Date Reviewed: 7/7/2016