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If couples have a problem with male-factor infertility due to low sperm count or slow motility, and have tried other clinical and laboratory types of treatment, Intracytoplasmic sperm injection (ICSI) is used to assist fertilization. IVF with ICSI has high rates of success. ICSI is a procedure that uses special tools and inverted microscopes that allow embryologists to choose individual sperm using a hollow ICSI needle. This sperm is then deposited in the cytoplasm of an egg. Normal fertilization is approximately 70- 85% of eggs injected with viable sperm.

This procedure is done when couples have sperm counts of less than 15 – 20 million per milliliter or sperm motility less than 35%, or very poor sperm morphology. It is often the next step when couples have had previously unsuccessful cycles of IVF. Also when couples have low yield of eggs due to low ovarian reserves, ICSC is being used to attempt to get a higher number of eggs fertilized. Obviously, the quality of the eggs is a critical factor in obtaining a quality embryo.