Intracytoplasmic Sperm Injection (ICSI)
Intracytoplasmic Sperm Injection (ICSI) is a breakthrough micromanipulation technique widely utilized in modern assisted reproductive technology (ART). It represents the cornerstone of fertilization in leading fertility centers worldwide.
Unlike standard in vitro fertilization (IVF), where thousands of sperm cells are placed around an egg to achieve spontaneous penetration, ICSI involves the direct mechanical injection of a single, carefully selected spermatozoon into the cytoplasm of a mature oocyte. This eliminates biological barriers related to sperm motility, count, or morphology.
Procedure Steps of ICSI
The ICSI protocol encompasses the following critical laboratory stages:
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Oocyte Retrieval (OPU): Following ovarian stimulation, mature eggs are collected from the ovaries under transvaginal ultrasound guidance.
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Sperm Preparation: The semen sample is processed and isolated in the laboratory, identifying spermatozoa with optimal motility and structural integrity.
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Microinjection: Under high-magnification inverted microscopy, the mature oocyte is held firmly with a holding pipette. A microscopic glass needle aspirates a single sperm cell and injects it directly into the egg's cytoplasm.
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Fertilization Assessment and Embryo Culture: The injected eggs are cultured in state-of-the-art incubators. Normal fertilization is verified within 16–18 hours, and subsequent embryonic cleavages are closely monitored through Day 3 or Day 5 (blastocyst).
Primary Indications
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Severe male-factor subfertility (oligozoospermia, asthenozoospermia, teratozoospermia)
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Obstructive or non-obstructive azoospermia requiring surgical retrieval (TESE/TESA)
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Unexplained fertilization failure in previous standard IVF cycles
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Cases with limited oocyte yield to ensure maximal fertilization chances
