ICSI: When and How It's Used

ICSI (Intracytoplasmic Sperm Injection) is a specific technique used when conventional IVF fertilisation is unlikely to succeed on its own.

When ICSI is indicated

ICSI is used when sperm are completely absent from the ejaculate (azoospermia), when sperm count, motility or morphology are poor, when sperm are retrieved surgically (via testicular biopsy, TESA, or PESA from the epididymis), or when a couple has had multiple fertilisation failures in previous IVF cycles.

How the procedure works

A single sperm is immobilised by breaking its tail, then injected directly into the cytoplasm of the egg using a fine injecting needle, while a separate stabilising needle holds the egg in place, positioned so the injection avoids the egg's polar body. This bypasses the natural fertilisation barrier entirely for cases where sperm quality or quantity would otherwise make conception very difficult.

This article is based on a Jivo Masterclass session conducted by Dr. Parul Prakash, Head, Reproductive Medicine (IVF), Artemis Hospital, Gurugram. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording

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