ICSI is helpful in the most severe male factor cases, where there are:

• Insufficient number of available sperms or severe Oligozoospermia
• Insufficient number of normal sperms or Teratozoospermia
• Low grade sperm motility or Asthenozoospermia
• Obstructive Azoospermia or Blockage in epididymis or vas deferens
• Congential absence of epdidymis or vas deferens
• Anti-sperm antibodies
• Failure of fertilization

 In females, ICSI is helpful in the following cases:

• Resistant zona pellucida
• Anti-sperm antibodies
• Failure of fertilization
• In older age group

Initial consultation:

This begins with an in-depth discussion of their fertility problems and the treatment received so far. Complete physical examination is then performed and in most of the cases an ultrasound examination is carried out at the same time. Based on the history and previous investigations, further investigations are advised or alternatively various treatment modalities are discussed. Initial consultation can take one to two hours of consultation time, and one hour of embryologists time to prepare a report of semen analysis.

Treatment and Management:

As far as the female patient is concerned, the procedure is exactly similar to that of IVF. Acquisition of sperm and subsequent laboratory technique is different for ICSI. Sperm can be provided by the husband in the form of semen or acquired through operation.

Surgical aspiration of sperms is carried out by a very fine needle attached to a syringe which is pushed into the tube carrying sperm from testis to the penis or a piece of testicular tissue is obtained surgically and processed in the laboratory to release entrapped mature sperms.

Individual mature sperm is then picked with a very fine needle through a very elaborate equipment and injected into the egg which is collected in a similar manner as IVF. The rest of the procedure is similar as IVF.