Reviewed by: Dr. Priyadatt Patel, Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead. Last updated: 26 May 2026.
Advanced ART · ICSI
Intracytoplasmic Sperm Injection (ICSI)
ICSI involves the direct injection of a single sperm into the cytoplasm of a mature oocyte under microscopic guidance. It is the standard treatment for severe male factor infertility and select other indications.
How it works
The ICSI procedure
After egg retrieval, mature oocytes are denuded of cumulus cells. A single morphologically normal sperm is immobilised and aspirated into a fine micro-injection needle, then injected directly into the ooplasm. Fertilisation is assessed 16-18 hours later.
Indications
When ICSI is needed
- Severe oligospermia (count below 5 million/ml)
- Severe asthenospermia (motility below 20 percent)
- Severe teratospermia (normal forms below 4 percent)
- Previous failed fertilisation with conventional IVF
- Surgically retrieved sperm (TESA, PESA, micro-TESE)
- Frozen-thawed sperm with limited yield
Outcomes
Fertilisation and pregnancy rates
ICSI achieves fertilisation rates of 70-80 percent per injected mature oocyte. Pregnancy and live birth rates per cycle depend primarily on female age and embryo quality, not on the use of ICSI itself.
Common questions
Frequently asked
Is ICSI safer than conventional IVF fertilisation?
For appropriate indications, yes – it bypasses sperm-related fertilisation failures. For non-male-factor cases, conventional IVF and ICSI give similar outcomes; routine ICSI without indication is not recommended.
Does ICSI increase the risk of birth defects?
Large registry studies show a small absolute increase in congenital anomalies with ICSI, primarily related to the underlying male factor (genetic causes of infertility) rather than the technique itself. We discuss this openly during consent.
What if even ICSI fails to achieve fertilisation?
Total fertilisation failure occurs in less than 3 percent of ICSI cycles. We investigate (oocyte activation defects, sperm chromatin issues) and adapt the next cycle accordingly.
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Dr. Priyadatt Patel
Senior Gynecologist · Advanced Laparoscopic Surgeon · IVF and Endometriosis Programme Lead
MS OBGyn · Pregnancy Care · Advanced Gynaecological Ultrasound · Fertility Preservation
ESHRE / ESGE / AAGL / ASRM guideline-aligned practice. 3D Karl Storz precision technique. Fertility-preservation-first philosophy. Evidence-based decisions, honest counselling, long-term outcomes orientation.
Endometriosis
Superficial to deep infiltrating, fertility-preserving excision
IVF & Fertility
Individualised protocols, ART Level 2 lab, transparent outcomes
Advanced Laparoscopy
3D Karl Storz precision, nerve-sparing technique
Pregnancy Care
Antenatal care, high-risk pregnancy, advanced ultrasound
Balaji Horizon Women Hospital
Science City Road, Ahmedabad 380060
Mon–Sat 11:00–20:00 · +91 97234 31544
Balaji Women Clinic (AEC)
Naranpura, Ahmedabad
Mon–Sat 08:30–10:30 · +91 70460 02566
