Male Infertility

    • 1 posts
    May 24, 2023 7:39 AM EDT


    Intracytoplasmic sperm injection (ICSI) is very similar to conventional IVF in that gametes (eggs and sperm) are collected from each partner, the difference being in the method of achieving fertilisation.

    ICSI refers to the laboratory procedure where a single sperm is picked up with a fine glass needle and is injected directly into each egg . It is carried out in the laboratory by experienced embryologists using highly specialised equipment. Candidates to potentially benefit from ICSI include:

    ➥ Low sperm count
    ➥ Abnormal sperm or low sperm motility
    ➥ Sperm retrieved surgically from the epididymis (MESA/PESA) or the testes
    ➥ Sperm retrieved from urine or following electro-ejaculation
    ➥ High levels of antibodies in the semen
    ➥ Previous fertilisation failure using conventional IVF

    The ICSI procedure fertilizes about 50 to 80 percent of eggs but fertilization isn’t guaranteed even when a sperm is injected into the egg. Once fertilization happens, the success rate for a couple using IVF-ICSI is same as a couple using conventional IVF.


    In most cases involving male factor, a conventional ICSI procedure is usually performed where an expert embryologist examines the sperms using a microscope with magnification up to 400x and selects the normal motile sperms. However, in cases where the sperm samples are extremely low or highly abnormal, the selection of sperms may be done through IMSI or Intracytoplasmic Morphological Sperm Injection, an improved variation of ICSI.

    IMSI is a technique that uses a high-powered microscope with magnification up to 6,000x to examine the sperms. The magnified digitally enhanced images of the sperm allow the embryologist to detect any structural alterations and abnormality that are otherwise hard to locate with conventional methods. This helps in the selection of the quality sperms with the most normal morphology for fertilization.


    Azoospermia is a condition where there are no sperm at all in a man’s ejaculated semen and there can be various reasons for this. Sperm production and delivery involves a system of tubes within the male reproductive system. Azoospermia can be caused by an abnormality or blockage in the epididymis or the vas deferens – referred to as obstructive azoospermia. In these cases, sperm are being produced in the testes, they just can’t get out in the semen. Sometimes however, sperm production in the seminiferous tubules does not occur at all or is happening at such a low level that sperm are not detectable in the ejaculate – referred to as non-obstructive azoospermia.

    This post was edited by vivaan thap at May 24, 2023 7:39 AM EDT