Procedure guide · Reproductive medicine and andrology
ICSI (intracytoplasmic sperm injection) is a form of IVF in which one sperm is injected directly into each egg. NHS fertility services use it mainly when sperm problems make standard IVF unlikely to work. The other stages are the same as IVF. In India it is offered by ART clinics registered under national law.
What is ICSI?
An NHS fertility unit at South Tees Hospitals describes ICSI as drawing a single sperm into a very fine glass needle and injecting it into the centre of the egg. The egg is checked the next day for fertilisation. If an embryo develops, it is transferred to the womb in the usual way.
The unit says the treatment is otherwise the same as IVF. The woman still has hormone medicine, monitoring scans and egg collection. The difference lies only in how the egg is fertilised. In standard IVF eggs and sperm are left together to fertilise on their own.
Who may it suit?
A fertility specialist decides. The NHS unit gives two main situations:
- a very low sperm count, where conventional IVF is unlikely to succeed
- no sperm in the ejaculate, where sperm may be retrieved surgically from the testicle and then used for ICSI
The same unit notes some risks to discuss. The injection can damage some eggs. Children born after ICSI have not yet been followed into adulthood. There is a theoretical small risk that male infertility could be passed to a son. Ask the clinic to explain these points for your situation.
Registration matters
In India ICSI is an assisted reproductive technology service. Check the clinic on the National ART and Surrogacy Registry before you commit. Surrogacy is not available to foreign nationals.
Which reports does a specialist usually ask for?
For the male partner, send all semen analysis reports with dates. Include any hormone tests, genetic tests or urology letters. If sperm retrieval has been done before, send the operation note. For the female partner, send hormone results, ultrasound reports and records of any earlier IVF or ICSI cycles. NHS guidance on IVF says blood tests for HIV, hepatitis B and hepatitis C are required. Ask the clinic which other tests it needs.
How do you plan an ICSI trip?
The stages match IVF: preparation, stimulation and monitoring, egg collection, ICSI in the laboratory, then embryo transfer. If surgical sperm retrieval is planned, the male partner may need his own consultation and procedure. Ask whether this happens on the day of egg collection or earlier, with sperm frozen. Both partners usually sign consent forms. After you return home, a local doctor can arrange the pregnancy test and early scans.
What should you ask the clinic?
- Why do you advise ICSI rather than standard IVF in our case?
- Will the male partner need surgical sperm retrieval, and who performs it?
- Is the clinic registered on the National ART and Surrogacy Registry?
- What happens to eggs or embryos that are not used?
- Which steps must both partners attend in person?
- How will you share the laboratory report with our doctor at home?
Questions people ask
Is ICSI the same as IVF?
ICSI is a form of IVF. The hormone treatment, egg collection and embryo transfer are the same. The only difference is fertilisation. In ICSI a single sperm is injected into each egg rather than eggs and sperm being left together.
Can ICSI help if there is no sperm in the semen?
An NHS fertility unit explains that sperm can sometimes be retrieved surgically from the testicle or nearby tubes and then used for ICSI. A specialist will assess whether this is possible for you and explain the procedure.
Does ICSI carry any extra risks?
The NHS unit notes that the injection can damage some eggs. It also mentions a theoretical small risk of passing male infertility to a son. The usual IVF risks still apply. Discuss these with the clinic before you consent.
Sources
- South Tees Hospitals NHS Foundation Trust: Intracytoplasmic sperm injection (ICSI)
- NHS: IVF
- National ART and Surrogacy Registry
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.