Male Infertility Treatment: Intracytoplasmic Sperm Injection (ICSI)

One of the advanced treatment options for male infertility or sperm problems is a procedure known as the intracytoplasmic sperm injection (ICSI). In this procedure, the sperm is injected into the middle of the egg in a lab setting so that the egg can be fertilized in a controlled environment.
ICSI is typically coupled with fertility treatments such as in vitro fertilization (IVF) and in vitro maturation (IVM), and is a relatively simple and inexpensive process. Here’s a close look at how the ICSI works for treating male infertility, and who the best candidates are for this procedure:

How ICSI Procedures Are Performed

Couples that have agreed to undergo the ICSI procedure need to visit a fertility clinic at several intervals throughout the woman’s menstrual cycle to undergo various tests and find out if they may benefit from this type of male infertility treatment. Pregnancy success rates with ICSI and in vitro fertilization procedures have shown to be significantly higher than for IVF without ICSI, but the success rates do vary by individual.
The process of intracytoplasmic sperm injections is relatively simple. First, the mature egg is held in place using a special pipette. A hollow needle is used to pick up a single sperm, and the sperm is inserted into the shell of the egg so that it reaches the cytoplasm. The sperm is then gently pushed into the cytoplasm, and the eggs are checked for evidence of fertilization the following morning.
This delicate procedure is performed in a sterile laboratory and has proven to be successful for the majority of patients. The quality of the eggs, the ICSI technique used and the skill of the fertility specialist performing the procedure all play a role in the success of the procedure. In some rare cases, assisted hatching may be performed on the embryo prior to transfer to further maximize the chance of pregnancy.

Best Candidates for Intracytoplasmic Sperm Injections

Many fertility clinics recommend ICSI for men who are struggling with severe male infertility problems, but others use ICSI as part of the IVF or IVM procedure. Some of the best candidates for intracytoplasmic sperm injections include:
  • Couples that do not want to undergo the donor sperm insemination procedure
  • Men with sperm concentrations of less than 15 to 20 million per millileter
  • Men with sperm motility of less than 35%
  • Couples who have experienced a low rate of fertilization with standard IVF treatments
  • Couples who have a low yield of eggs with IVF treatments

Other Treatment Options for Male Infertility

In addition to intracytoplasmic sperm injections, male infertility is commonly treated with the following procedures:
  • Assisted reproduction therapies such as electroejaculation and gamete intrafallopian transfer (GIFT)
  • Drug therapies that increase sperm production and treat testosterone deficiencies
  • Surgery such as vasoepididymyostomy that corrects obstructions in the testes, or vericocelectomy, the removal of a varicocele from the testes to increase the sperm count
Learn more about fertility treatments in our information guide, or consult with an infertility specialist in your area to find out if you are a good candidate for any of these male infertility treatments.