How ICSI differs from standard IVF
In standard IVF, each egg is placed in a dish with thousands of sperm and fertilisation happens on its own. In ICSI, the embryologist holds the egg steady with a fine glass pipette and uses an even finer needle to place a single sperm inside it. Everything else, from injections to egg collection and embryo transfer, stays the same for you.
When ICSI is advised
- Low sperm count, poor movement or a high share of abnormally shaped sperm.
- Sperm taken surgically from the testis or epididymis (TESA, PESA or micro-TESE).
- Very few eggs, where every egg counts.
- Fertilisation failed or was very low in a previous IVF cycle.
- Frozen eggs, or when embryos will undergo genetic testing.
When sperm is normal, standard IVF works just as well for most couples. Dr. Prachi recommends ICSI when your reports show a clear reason for it.
The ICSI process
- Egg collectionAs in IVF, eggs are collected under short anaesthesia.
- Sperm preparationThe semen sample (or surgically retrieved sperm) is processed to select the healthiest, best moving sperm.
- InjectionEach mature egg receives one sperm under a high-power microscope.
- Fertilisation checkThe next morning, embryologists check how many eggs fertilised normally.
- Embryo culture and transferEmbryos grow for three to five days, and one is transferred or frozen.
Safety and what to expect
ICSI has been used worldwide since the early 1990s and millions of children have been born after it. A small number of eggs can be damaged during injection. Some studies suggest a slightly higher risk of certain conditions in children born through ICSI, often linked to the underlying male factor rather than the technique. Where a genetic cause of low sperm count is suspected, testing before treatment may be advised. Dr. Prachi will go through these points with you before you decide.
Getting the male side ready
Sperm takes about three months to develop. Stopping smoking, cutting alcohol, keeping laptops off the lap, managing weight and treating infections can all improve the sample. See the male infertility page for more.
Questions couples ask
Does ICSI improve the chance of pregnancy?
ICSI improves fertilisation when there is a sperm problem. Once embryos form, pregnancy chances depend mainly on egg quality and age, just like IVF.
Can ICSI work with zero sperm in the semen?
Sometimes. If sperm can be retrieved surgically from the testis, ICSI can use it. A urologist and fertility team assess this together.
Is ICSI more expensive than IVF?
There is usually an extra lab charge for ICSI. The clinic team will share the exact cost for your plan.
Does ICSI hurt more for the woman?
No. Your side of treatment is the same as IVF. The injection happens in the lab.
This page gives general information only. Dr. Prachi will advise on what suits you after reviewing your history and reports.
Medically reviewed by Dr. Prachi Benara, MS, DNB, MRCOG (London). Last updated October 2026.