How ICSI Is Performed: What the Embryologist Does From Sperm Selection to Injection

The couple sitting across from the fertility nurse had arrived with a folder of test results and one word circled in pen: ICSI. He had read that his sperm count was low. She had read that a needle would go into her eggs. Neither of them could picture what happened between those two facts, and the printed leaflet, all acronyms and arrows, did not help.

That gap is worth closing. Understanding how ICSI is performed turns an anxious blank into a sequence of small, deliberate actions that a trained embryologist carries out at a microscope, most of them lasting minutes. It also makes the conversation with your care team far more useful, because you know which questions actually matter.

This explainer walks through the lab side of the process, from the moment a semen sample arrives to the moment a single sperm is placed inside an egg, and then through the days that follow. The goal is accuracy, not reassurance for its own sake.

How ICSI is performed: the whole picture in plain language

ICSI stands for intracytoplasmic sperm injection: the placing of one sperm directly into the inner fluid, or cytoplasm, of an egg. It is not a separate treatment from IVF. In vitro fertilization, or IVF, is the process of collecting eggs, fertilizing them outside the body, and transferring an embryo into the uterus. ICSI simply replaces the fertilization step, swapping the natural encounter between egg and many thousands of sperm for a single, embryologist-guided injection.

Everything else stays the same. The ovaries are stimulated with hormone injections so that several eggs mature at once. Those eggs are collected through the vaginal wall under ultrasound guidance in a short procedure that the NHS describes as taking around 15 to 20 minutes. A semen sample is produced the same day, or thawed from storage, or retrieved surgically if no sperm are present in the ejaculate.

In the laboratory, the embryologist works on three things in parallel. The sperm are washed and concentrated. The eggs are freed from the cloud of supporting cells that surrounds them so their maturity can be judged. Then, at a microscope fitted with two fine glass tools, the embryologist catches one sperm, stills its tail, and delivers it into each mature egg.

The injected eggs go into an incubator that mimics the body’s temperature and gas mix. Roughly a day later they are examined for signs that fertilization has occurred. Embryos that develop are cultured for several more days and then either transferred to the uterus or frozen.

According to Cleveland Clinic, ICSI is now used in the majority of IVF cycles in the United States, which tells you two things: the technique is routine for the people performing it, and it is not reserved for rare cases.

Who is ICSI usually for, and who is usually asked to wait?

ICSI was developed for one problem: sperm that cannot fertilize an egg on their own. The clearest reasons to use it, as set out in national guidance such as that from NICE in the UK and echoed by the NHS, are a severely reduced sperm count, very poor sperm movement or shape, sperm retrieved surgically from the testicle or epididymis, and a previous IVF cycle in which few or no eggs fertilized despite normal-looking semen.

Some laboratories also use ICSI when eggs are being tested genetically before transfer, so that stray sperm stuck to the egg’s outer shell do not contaminate the sample, or when previously frozen eggs are being fertilized, because freezing can harden the egg’s outer layer. Your embryology team will explain the rationale if either applies to you.

Who is usually asked to wait, or steered toward conventional IVF instead? Couples with normal semen parameters and no history of fertilization failure. Guidance from NICE is explicit that ICSI does not improve the chance of a live birth when the sperm are normal, and the NHS notes that it is generally offered where male-factor infertility is the issue. In that situation, letting eggs and sperm meet naturally in the dish carries the same outcomes with one fewer manipulation of the egg.

There are also situations in which the whole cycle, not just ICSI, is paused. A poor response to ovarian stimulation, signs of ovarian hyperstimulation syndrome (a swelling and fluid-shift reaction to fertility hormones), or an unexpected illness on retrieval day can all lead a team to defer. Those decisions belong to the treating clinicians, who can see the full picture of hormone levels, scans and test results.

Is ICSI painful? What the patient actually feels on retrieval day

The injection of sperm into an egg happens under a microscope, in a dish, away from your body. You feel nothing from that step at all. When people search whether ICSI hurts, they are usually asking about the parts that do involve them: the hormone injections, the egg collection, and the semen sample or surgical sperm retrieval.

Ovarian stimulation involves daily injections under the skin for roughly a week and a half to two weeks, according to the NHS. Most people describe them as a brief sting, with bloating and breast tenderness building toward the end as the ovaries enlarge. Your prescribing team will set the plan and adjust it based on scans and blood tests; this article does not cover medication schedules.

Egg collection is done with sedation or a general anesthetic, the NHS explains, using a needle passed through the vaginal wall under ultrasound guidance. Afterward, period-like cramping and light spotting for a day or so are common. Mayo Clinic notes that pressure, cramping and a feeling of fullness are the typical after-effects.

For the male partner, producing a sample by masturbation is not painful, though it can be stressful under time pressure. Surgical sperm retrieval, in which sperm are taken directly from the testicle or the epididymis (the coiled tube where sperm mature), is performed under local or general anesthetic. Soreness and swelling in the scrotum for a few days afterward are expected, and the urology team will advise on rest and supportive underwear.

Embryo transfer, a few days later, is generally done without anesthetic and feels similar to a cervical screening test.

How is the sperm sample prepared for ICSI?

A raw semen sample is a poor starting material for micro-injection. It is thick, contains dead and immotile cells, debris, white blood cells and prostaglandins, and would clog the fine glass pipettes used later. So the first thing the embryologist does is separate the usable sperm from everything else.

Two preparation methods dominate. In density gradient centrifugation, the sample is layered on top of a column of fluid of increasing density and spun. Healthy, well-formed sperm are dense enough to travel down through the layers, while debris and abnormal cells are left behind. In the swim-up technique, sperm are given a layer of clean culture medium above them; only motile sperm swim up into it, and that top layer is collected. The choice depends on the quality of the sample and laboratory protocol.

For very low counts, the whole sample may instead be gently spun and concentrated into a tiny volume, then searched drop by drop. For surgically retrieved tissue, the embryologist minces the tissue and looks through the suspension for any sperm at all, a process that can take hours.

Frozen samples are thawed in a controlled way, since ice crystal damage is a real hazard, and then prepared like a fresh sample. Freezing lowers motility, so the search may take longer.

The prepared sperm are placed into a droplet of viscous fluid on the ICSI dish. This thick medium slows the sperm down, making individual ones easier to follow and catch. It also means the embryologist can watch a sperm’s movement pattern for several seconds before deciding whether to choose it.

How does the embryologist select a single sperm for ICSI?

With conventional IVF, the egg does the choosing. Only sperm that can swim through the cumulus cells, bind the zona pellucida (the egg’s protective glycoprotein shell) and complete a chemical handshake get through. ICSI bypasses all of that, so the embryologist’s judgment becomes the filter.

The criteria are visual, and they are made under high magnification, typically 200 to 400 times, using optics that reveal the sperm’s outline in fine relief. The embryologist looks for a sperm that is moving, because movement indicates it is alive, and that has a normal shape: an oval head, a clearly defined midpiece, a single straight tail. Sperm with two heads, coiled tails, pinhead or very large heads, or large vacuoles in the head are passed over.

In samples where nearly every sperm looks abnormal, the embryologist picks the least abnormal available. When no sperm are moving, which happens with some surgically retrieved samples, a viability test may be used: a gentle chemical or mechanical stimulus that causes a live but still sperm to twitch or curl its tail, distinguishing it from a dead one.

Some laboratories use higher-magnification systems to inspect the head in more detail, or select sperm based on their ability to bind to a substance similar to the egg’s outer coating. It is fair to say the evidence that these refinements improve live birth rates is not settled, and national guidance does not require them. Your team can tell you which selection method is standard in their laboratory and why.

Once a candidate is chosen, the embryologist follows it with the injection pipette, ready for the next step.

Preparing the egg: removing the cumulus and checking maturity

Eggs arrive from the retrieval room wrapped in a fluffy halo of cumulus cells, the nurse cells that supported them inside the follicle. In conventional IVF those cells are left on. For ICSI they have to come off, for two reasons: the embryologist cannot see the egg clearly through them, and the injection pipette would snag.

The eggs are placed briefly in a solution containing hyaluronidase, an enzyme that loosens the sticky matrix holding cumulus cells together. Then, using a pipette only slightly wider than the egg itself, the embryologist draws each egg in and out until the last cells are stripped away. This is done quickly and gently; the egg is fragile, and time outside the incubator is kept to a minimum.

Now the egg can be graded for maturity, which is the crucial gate. Only a mature egg, one that has completed the first stage of meiosis (the cell division that halves its chromosomes), can be fertilized normally. The visible marker is the first polar body: a small round cell tucked between the egg and its shell, containing the discarded half set of chromosomes. An egg with a polar body is called metaphase II and is ready for injection.

Eggs without a polar body are immature. Some show a visible nucleus and are hours or a day away from readiness; others are in between. Laboratory practice varies on whether immature eggs are cultured a little longer and re-checked, or set aside. Eggs that are dark, grainy, fragmented, or have an empty or damaged shell are noted but generally not injected.

The mature eggs are moved into individual droplets on the ICSI dish, near the droplet of prepared sperm.

The ICSI procedure step by step: what happens under the microscope

The injection is performed on an inverted microscope fitted with two micromanipulators, joystick-controlled arms that translate a hand movement of centimeters into a tool movement of microns. A heated stage keeps the dish at body temperature.

On the left, a blunt holding pipette applies gentle suction to anchor the egg. The embryologist rotates the egg so that the polar body sits at the twelve or six o’clock position. This matters: the egg’s chromosome spindle usually lies close to the polar body, and injecting at three o’clock keeps the needle well away from it.

On the right is the injection pipette, a glass needle with a beveled tip a few microns across, thinner than a human hair. The embryologist moves it into the sperm droplet, selects the chosen sperm, and presses the pipette across its tail against the bottom of the dish. This crushes the tail membrane and stops the sperm moving. Immobilization is not incidental. It appears to help release factors from the sperm that trigger the egg to activate, and it prevents a thrashing sperm from damaging the egg’s interior.

The immobilized sperm is drawn tail-first into the needle, then repositioned so it will exit head-first. The pipette is moved to the egg, aligned at three o’clock, and pushed through the zona pellucida and into the egg’s outer membrane, the oolemma. The membrane is elastic and often dimples deeply without breaking. A small amount of cytoplasm is gently aspirated into the needle until the membrane gives way with a visible release, confirming entry. The sperm is then expelled with the minimum of fluid, and the needle is withdrawn slowly so the membrane reseals.

Each egg takes a skilled embryologist a minute or two. The dish returns to the incubator promptly.

ICSI vs IVF difference: what actually changes in the lab

People often talk about ICSI and IVF as if they were rival treatments. They are better understood as two ways of handling one step. The table below sets out where they differ and where they are identical.

Stage	Conventional IVF	ICSI
Ovarian stimulation and monitoring	Same	Same
Egg retrieval	Same, around 15–20 minutes (NHS)	Same
Sperm preparation	Washed and concentrated	Washed and concentrated, then placed in viscous medium for selection
Cumulus cells	Left on the egg	Removed with enzyme and pipetting
Fertilization method	Tens of thousands of sperm incubated with each egg	One sperm injected into each mature egg
Egg maturity check	Not possible before fertilization	Done before injection; immature eggs identified
Main indication	Normal semen parameters, tubal or unexplained infertility	Male-factor infertility, surgically retrieved sperm, prior fertilization failure
Fertilization check, embryo culture, transfer	Same	Same

Two consequences follow. First, ICSI gives the laboratory information it would not otherwise have: how many eggs were actually mature. In conventional IVF an immature egg simply fails to fertilize and looks the same as a mature egg that met poor sperm. Second, ICSI removes natural sperm selection. A sperm that could never have penetrated an egg unaided can now fertilize it, which is the point for severe male-factor infertility but is also why guidance does not recommend ICSI when sperm are normal.

Fertilization rates per injected mature egg are broadly comparable between the two methods when semen is normal, and Cleveland Clinic cites fertilization in roughly 50% to 80% of eggs after ICSI. Fertilization, though, is only one hurdle on the way to a pregnancy.

Can ICSI damage eggs?

Yes, a small proportion of eggs do not survive the injection. Cleveland Clinic and other major centers describe this openly as a known risk of the technique. The egg is a single cell about a tenth of a millimeter across, and pushing a glass needle through its membrane is a mechanical insult, however delicate the hands.

Damage usually shows up within an hour or two as degeneration: the cytoplasm darkens and shrinks, and the membrane fails to reseal. Several factors raise the risk. Eggs with fragile or very elastic membranes, eggs from women with a poor ovarian response, and eggs that have been frozen and thawed all tend to be more vulnerable. Technique also matters; aspirating too much cytoplasm or injecting too much fluid can rupture the cell.

What the injection does not do, when performed correctly, is disturb the chromosomes. That is precisely why the polar body is oriented away from the entry point and why the embryologist stays clear of the region where the spindle usually sits. Injection at the wrong position has been associated with poorer development in laboratory studies, which is why positioning is a standard part of training.

Two subtler concerns deserve honest treatment. The first is that ICSI can fertilize an egg with a sperm carrying a genetic problem that natural selection might have excluded. This is why men with very low or absent sperm counts are often offered genetic testing before treatment, so the couple understands what could be inherited. The second is that some eggs fertilize abnormally, with one or three sets of chromosomes rather than two; these are identified at the fertilization check and are not used.

Your embryology team should tell you how many eggs were injected, how many survived, and how many fertilized normally. Those three numbers, not a single headline, describe your cycle.

What happens in the days after ICSI: from fertilization check to transfer

Injection is the end of the embryologist’s most delicate work but the beginning of the waiting. The dish goes back into an incubator set to body temperature, low oxygen and a controlled level of carbon dioxide, conditions designed to imitate the fallopian tube.

The next morning, roughly 16 to 18 hours after injection, each egg is examined for fertilization. The sign the embryologist wants is two pronuclei: two small circles inside the egg, one carrying the mother’s chromosomes and one the father’s, sitting side by side before they merge. A second polar body is usually visible too. An egg with two pronuclei has fertilized normally. One pronucleus or three indicates abnormal fertilization, and those eggs are excluded.

Over the following days the embryos divide. By day two most are at two to four cells; by day three, six to eight; by day five or six, a healthy embryo has become a blastocyst, a hollow ball of a hundred or more cells with a distinct inner cell mass that will become the fetus. Mayo Clinic notes that embryo transfer usually takes place two to five days after egg retrieval, and many laboratories now favor day five so they can select embryos that have proven they can reach blastocyst stage.

Some embryos stall and stop dividing. This is expected, and it reflects the embryo’s own biology far more than anything the laboratory did.

Transfer itself is a short, usually anesthetic-free procedure in which one embryo, occasionally two, is placed in the uterus through a thin catheter. Remaining good-quality embryos can be frozen. A pregnancy blood test follows around 12 days to two weeks after retrieval, according to Mayo Clinic. The NHS notes that until then, the only reliable answer to whether it worked is that no one yet knows.

What the evidence says about ICSI results, and what it does not

The most searched question about ICSI is also the one this article will not answer with a single number, because no honest single number exists. Live birth after IVF, with or without ICSI, depends heavily on the age of the woman providing the eggs, the number and quality of embryos, the reason for infertility, and whether a fresh or frozen transfer is used. The CDC publishes detailed national data on assisted reproductive technology outcomes, broken down by age and cycle type, and that is the appropriate place to look at population averages rather than a marketing headline.

What is well established is narrower and more useful. ICSI reliably achieves fertilization when sperm are too few or too weak to do it alone; Cleveland Clinic gives a fertilization range of roughly 50% to 80% of injected eggs. For couples with severe male-factor infertility, this converts an impossible situation into a workable one.

Equally well established is what ICSI does not do. When semen parameters are normal, using ICSI instead of conventional IVF does not raise the live birth rate; NICE guidance states this directly, and it is the reason ICSI is not recommended routinely for unexplained infertility. Fertilizing an egg is only the first of many hurdles, and ICSI addresses only that one.

First-cycle success, another common query, is best discussed with your own team, who can place your age, ovarian reserve and semen results against their laboratory’s audited figures. Any clinic that quotes you a single percentage without those qualifiers is telling you less than it seems.

Fairly stated, the evidence supports ICSI as an effective solution to a fertilization problem, and as no more than that.

Is ICSI more likely to give a boy or girl, and is it safe for the baby?

ICSI does not select the sex of the embryo. The embryologist chooses a sperm by its shape and movement, and no one can tell under a microscope whether a sperm carries an X or a Y chromosome. Some large registry analyses have reported a marginally lower proportion of boys after ICSI compared with conventional IVF or natural conception, while others found no meaningful difference. The shift, where it appears, is small and inconsistent, and it is not something any couple should plan around.

Safety for the child is a more substantive question. Children conceived through IVF, including ICSI, have a slightly higher rate of birth defects than children conceived naturally, as Cleveland Clinic and Mayo Clinic both note. The absolute increase is small, and untangling how much comes from the technique and how much from the underlying infertility, or from the parents’ age, is genuinely difficult. Men with very low sperm counts more often carry genetic changes, including small deletions on the Y chromosome and chromosomal rearrangements, and sons conceived with their sperm may inherit them. This is why genetic counseling is often offered before ICSI for severe male-factor infertility.

Long-term follow-up of ICSI-conceived people, now into adulthood for the earliest cohorts, has been broadly reassuring on growth, development and general health. Some studies have reported lower semen quality in young men conceived by ICSI for paternal infertility, consistent with inheritance rather than the procedure.

Risks that come from IVF generally, rather than from ICSI specifically, include multiple pregnancy when more than one embryo is transferred, ectopic pregnancy, and ovarian hyperstimulation syndrome for the woman, all of which the NHS lists among IVF risks. Your team will explain how they minimize each.

What people often get wrong about ICSI

“ICSI is the upgraded version of IVF.” It is not a tier or a premium package. It is a technique for a specific problem, poor sperm function, and guidance from NICE is clear that it adds nothing to live birth rates when sperm are normal. Choosing it without a reason means one more manipulation of the egg for no gain.

“The embryologist picks the best sperm, so the embryo will be healthier.” Selection is visual. A normal-looking sperm can carry abnormal DNA, and a slightly odd-looking one can be genetically fine. ICSI ensures fertilization; it does not guarantee embryo quality.

“ICSI means every egg will fertilize.” Cleveland Clinic’s figure of roughly 50% to 80% fertilization is the realistic range. Some eggs are immature and cannot be injected, some do not survive the needle, and some fail to activate even with a sperm inside.

“The injection hurts.” The injection happens to an egg in a dish. Any discomfort belongs to stimulation, retrieval or sperm retrieval, not to ICSI itself.

“ICSI lets you choose a boy or a girl.” It cannot. Sperm sex is invisible under a microscope.

“If the first ICSI cycle fails, the technique failed.” Most cycles that do not result in a baby fail after fertilization, at the embryo development or implantation stage. Those stages are governed by egg and embryo biology, and by the uterus, not by how the sperm got in.

“Lifestyle does not matter once you’re doing ICSI.” Sperm DNA quality is affected by smoking, heat exposure and some medical conditions, and the NHS advises attention to these before any fertility treatment. Injection bypasses movement problems; it does not repair damaged DNA.

Questions to ask your care team before ICSI

A good consultation before ICSI should leave you with specific answers, not general reassurance. These are questions embryologists and fertility clinicians expect and are usually glad to be asked.

• Why is ICSI being recommended for us rather than conventional IVF, and which of our test results drives that decision?
• If our semen results are borderline, would you consider splitting the eggs between conventional IVF and ICSI?
• How will the sperm sample be prepared, and what happens if the fresh sample on the day is much worse than the earlier tests?
• Is a backup frozen sample advisable before the cycle starts?
• If surgical sperm retrieval is planned, will it be done before egg collection or on the same day, and what happens if no sperm are found?
• Should we have genetic testing or counseling before treatment given the cause of the male-factor infertility?
• How and when will we be told how many eggs were collected, how many were mature, how many survived injection and how many fertilized?
• Do you culture embryos to day five, and how do you decide which embryo to transfer?
• How many embryos do you recommend transferring, and why?
• What is your laboratory’s own audited fertilization rate after ICSI, and how does that compare with published ranges?
• What are the signs of ovarian hyperstimulation syndrome I should watch for, and who do I call out of hours?
• What happens to embryos that are not transferred, and what are our options for storage?

Write the answers down. In the compressed, emotional days of a treatment cycle, remembering exactly what was said becomes surprisingly hard, and the numbers your team gives you at each stage are the truest measure of how your cycle is going.

When to call your doctor during or after an ICSI cycle

Because the injection itself happens in the laboratory, the medical risks of an ICSI cycle are the risks of IVF: the hormone stimulation, the egg collection, any surgical sperm retrieval, and the early pregnancy that may follow. Most people experience bloating, mild cramping and tiredness and need nothing more than rest. Some symptoms, though, should never be waited out.

Contact your fertility unit or seek urgent care the same day if you develop rapidly increasing abdominal swelling or a tight, distended belly; severe or worsening abdominal pain; persistent nausea or vomiting so that you cannot keep fluids down; passing much less urine than usual or dark urine despite drinking; breathlessness, chest pain or difficulty lying flat; or sudden weight gain over a day or two. These can indicate ovarian hyperstimulation syndrome, which the NHS lists among the significant risks of IVF, and its severe form needs prompt hospital assessment.

Seek emergency care for heavy vaginal bleeding soaking through pads, a high fever with chills after egg collection, fainting, or a painful, swollen, hot calf, which can signal a blood clot. After surgical sperm retrieval, call the urology team for rapidly enlarging scrotal swelling, spreading redness, pus, or fever.

If a pregnancy test is positive, one-sided pelvic pain, shoulder-tip pain, dizziness or bleeding warrant same-day review to rule out an ectopic pregnancy, a risk the NHS notes is slightly raised after IVF.

Every unit has an emergency contact number for patients in treatment. Save it in your phone before the cycle begins, and use it. The team would far rather hear from you about something that turns out to be minor than miss a complication that needed care.

Frequently asked questions

What is the ICSI procedure step by step?

In order: eggs are collected and stripped of their surrounding cumulus cells; a semen sample is washed and concentrated; each egg is checked for maturity; the embryologist selects one moving, normally shaped sperm, immobilizes it by pressing on its tail, draws it into a fine glass needle and injects it into the egg’s cytoplasm away from the chromosome spindle; the eggs are incubated and checked for fertilization the next morning.

Is ICSI a painful procedure?

No, the injection itself happens to an egg in a laboratory dish and you feel nothing. Any discomfort in an ICSI cycle comes from the hormone injections, the egg collection (done under sedation or anesthetic, with cramping afterward) and, for some men, surgical sperm retrieval, which can leave the scrotum sore for a few days. Embryo transfer usually feels like a cervical screening test.

Can ICSI damage eggs?

Yes, a small proportion of eggs degenerate after injection because the glass needle ruptures the cell membrane. Cleveland Clinic lists this as a recognized risk. Eggs with fragile membranes, eggs from a poor ovarian response and previously frozen eggs are more vulnerable. Correctly performed, the injection avoids the chromosome spindle. Your team should tell you how many eggs were injected, how many survived and how many fertilized.

What is the ICSI vs IVF difference in simple terms?

The only difference is how the sperm reaches the egg. In conventional IVF, tens of thousands of sperm are placed with each egg and one fertilizes it naturally. In ICSI, an embryologist injects a single sperm into each mature egg. Stimulation, egg collection, embryo culture and transfer are the same. ICSI is used when sperm cannot fertilize an egg on their own.

How successful is ICSI for the first time?

There is no single honest figure, because live birth depends mainly on the age of the woman providing eggs, embryo quality and the cause of infertility, not on ICSI itself. ICSI reliably solves the fertilization problem, with Cleveland Clinic citing 50% to 80% of injected eggs fertilizing. For your own likelihood, ask your team to interpret their audited results against your specific circumstances rather than quoting a general average.

Is ICSI more likely to give a boy or a girl?

ICSI does not select sex; a sperm’s X or Y chromosome is invisible under a microscope. Some large registry studies have reported a slightly lower proportion of boys after ICSI compared with conventional IVF, while others found no difference. The effect, where seen, is small and inconsistent, and it should not influence a decision about whether to use the technique.

How does the embryologist choose which sperm to inject?

By appearance and movement under high magnification. The embryologist looks for a sperm that is moving, indicating it is alive, with an oval head, intact midpiece and a single straight tail, and avoids sperm with two heads, coiled tails or large vacuoles. When none are moving, a viability test can distinguish live from dead sperm. Selection cannot see the DNA inside, so it ensures fertilization rather than guaranteeing embryo quality.

Why are only some of my eggs injected?

Because only mature eggs can be fertilized normally. After the cumulus cells are removed, the embryologist looks for the first polar body, a small cell beside the egg that shows it has completed the first division of meiosis. Eggs without it are immature and are either cultured briefly and re-checked or set aside, depending on laboratory practice. Degenerated or damaged eggs are also excluded.

What happens if no sperm are found on the day of ICSI?

Your team will have discussed contingency plans beforehand. Options commonly include using a backup frozen sample if one was stored, attempting or repeating surgical sperm retrieval, freezing the collected eggs for later use, or using donor sperm if that was agreed in advance. Which path applies depends on your circumstances and consent decisions, and the treating team will guide you through it on the day.

Is ICSI safe for the baby in the long term?

Follow-up of ICSI-conceived children into adulthood has been broadly reassuring on growth, development and general health. IVF including ICSI carries a slightly higher birth-defect rate than natural conception, as Mayo Clinic and Cleveland Clinic note, and much of this is attributed to underlying infertility and parental age. Sons of men with severe male-factor infertility may inherit related genetic changes, which is why genetic counseling is often offered beforehand.

References

• NHS: IVF, what happens
• NHS: IVF, risks

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.