ICSI (Intracytoplasmic Sperm Injection): Advancing Assisted Reproduction
Dr. Parul Agrawal provides ICSI treatment in Noida. ICSI (intracytoplasmic sperm injection) is a type of IVF in which the embryologist places one carefully selected sperm directly into a mature egg in the lab. It is mainly advised when the sperm count, movement or shape is poor, when sperm is collected by a procedure such as TESA or PESA, or when eggs did not fertilise in an earlier IVF cycle. It is not needed for every couple, and it does not guarantee that an egg will be fertilise.
ICSI is not a separate treatment from IVF. It is a different way of fertilising the eggs within an IVF cycle. And it is not needed for everyone. This page explains when it helps, when it does not, and what to expect from Intracytoplasmic Sperm Injection Procedure.
Dr. Parul has 23+ years of experience in obstetrics, gynaecology and reproductive medicine, and has performed 12,000+ IVF cycles at her clinic in Sector 92, Noida, she sees every patient personally.
What is ICSI (intracytoplasmic sperm injection)?
In standard IVF, thousands of prepared sperm are placed in a dish with the eggs, and one selected sperm enters an egg. In ICSI, the embryologist chooses one healthy sperm for each mature egg and injects it straight into the egg with a very fine glass needle, under a high-power microscope.
Everything else is the same as in an IVF cycle. You take injections to help several eggs to mature, the eggs are collected under sedation, and the embryo is placed in the uterus later. See IVF treatment for the full cycle.
Who needs ICSI treatment, and who does not
ICSI may be advised if:
- The sperm count is very low, or sperm movement or shape is poor (severe male factor infertility).
- Eggs did not fertilise, or fertilised poorly, in an earlier standard IVF cycle.
- Sperm have to be collected by a small procedure from the testis or epididymis, because there are no sperm in the semen.
- Only a few sperm are available, or a frozen sperm sample is of poor quality.
- Frozen and thawed eggs are used.
- Embryos will be genetically tested (PGT), where ICSI is commonly used.
ICSI is not needed for everyone. If there is no male factor problem, studies have not shown that ICSI gives a better chance of a baby than standard IVF. Fertility societies such as ESHRE and ASRM do not recommend using it in a routine in such cases. It adds cost and an extra step without having a clear benefit.
At your consultation, Dr. Parul checks your semen report and history and tells you honestly whether you need ICSI. Sometimes eggs are divided, so some are fertilised by standard IVF and some by ICSI.
ICSI vs IVF: what is the difference?
Standard IVF
- Eggs and prepared sperm are placed together, and a sperm enters on its own
- Many healthy, moving sperm
- Blocked tubes, endometriosis, unexplained infertility with normal sperm
- Stimulation, retrieval, transfer
- Lower
- Depends mostly on the woman’s age, egg and embryo quality
- IVF risks
ICSI
- One selected sperm is injected into a healthy egg
- One sperm for a healthy egg
- Many male factor, earlier fertilisation failure, frozen eggs, genetic testing
- Stimulation, retrieval, transfer
- Usually an extra charge over the IVF cycle
- Same. ICSI mainly helps eggs fertilise when sperm is the problem.
- IVF risks, and a small chance that an egg is damaged during injection
ICSI is not a “better IVF.” It solves one problem: getting sperm and egg together. If sperm is not the problem, it adds little.
Not sure which one suits you? Our blog also compares IVF, IUI and ICSI. If your case is mild, IUI may be enough.
ICSI fertility treatment: what affects success
ICSI can give a chance to fertilise eggs when sperm is the problem. But a fertilised egg still has to grow into a healthy embryo and implant. Success depends mainly on:
- The woman’s age, a huge factor, because the egg numbers and quality goes down with the age.
- Sperm quality, including the health of its DNA, and the source of the sperm.
- Embryo quality and lab conditions.
- The uterus, such as the lining, fibroids, polyps or scar tissue.
- Lifestyle, such as smoking, alcohol, weight and stress.
Even with ICSI, fertilisation can fail, though this is uncommon. No one can promise you a pregnancy. Dr. Parul gives you a real hope after having your all tests report.
Tests before ICSI
- Semen analysis (sperm count, movement and shape), usually repeated.
- Hormone tests for the man, if the result is abnormal.
- A scrotal examination or scan, if needed, to look for problems such as varicocele.
- Genetic tests, such as a karyotype or a Y-chromosome microdeletion test, may be advised when the sperm count is very low or absent.
- For the woman: a scan and an egg reserve test (AMH), and other tests as needed.
See our pages to know more about male infertility treatment and fertility counselling and tests.
Risks and what to know before ICSI
ICSI has the same risks as IVF, plus a few of its own:
- IVF risks: bloating and mood changes from medicines, ovarian hyperstimulation (OHSS, uncommon), twins or more if more than one embryo is transferred, ectopic pregnancy, and rarely infection or bleeding after an egg retrieval.
- ICSI-specific: an egg can occasionally be damaged during injection. An egg may still fail to fertilise, or an embryo may not develop.
- Babies born after ICSI are generally healthy. Some studies show a slightly higher rate of birth defects or genetic conditions than after natural conception. This may be linked to the cause of male infertility and the parents’ age, rather than ICSI itself.
- If the cause of low sperm count is genetic, sons conceived through ICSI may have the same problem. Dr. Parul may advise genetic counselling or testing in such cases. [CONFIRM WITH DOCTOR]
- Emotional strain. Fertility treatment can be stressful for both partners.
Call the clinic or go to an emergency room if you have such pain, heavy bleeding, fever, rapid weight gain or breathlessness.
ICSI cost in Noida
ICSI is usually an extra charge on top of an IVF cycle. At our clinic, ICSI adds about ₹[ADD-ON RANGE] to the IVF cycle cost of about ₹[IVF RANGE]. [OR: a complete IVF + ICSI cycle costs about ₹[TOTAL RANGE]]. This includes [LIST WHAT IS INCLUDED] and does not include [LIST: for example, medicines, embryo freezing and storage, genetic testing, sperm retrieval]. [CONFIRM ALL]
These things can change your cost:
- The type and dose differ from person to person.
- Sperm retrieval, if sperm cannot be collected from semen analysis.
- Embryo freezing, storage and later frozen transfers.
- Genetic testing of embryos (PGT).
- The number of cycles you need.
After your consultation, we give you a written estimate. If you do not need ICSI, you do not pay for it.
Why meet Dr. Parul Agrawal for ICSI
- You meet Dr. Parul She look at every patient personally and performs your procedures carefully.
- 23+ years of experience and 12,000+ IVF cycles. This means she can advise you honestly on whether you need ICSI treatment in your current situation or not.
- Plain language. She explains each step, as many times as you need.
- Honest expectations. No one can promise a guarantee pregnancy to you.
Book your appointment. Appointments are booked by phone at [PHONE], 9:30 am – 5:00 pm, [DAYS]. Our clinic is at A-127, Block A, Sector 92, Noida, Uttar Pradesh 201304. See directions and timings.
Frequently asked questions
Is ICSI the same as IVF?
No. ICSI is a way of fertilising eggs within an IVF cycle. Everything else, such as injections, egg retrieval and an embryo transfer, is same.
Is ICSI painful?
For you, ICSI feels the same as IVF. The injection is done on the egg in the lab, so you feel nothing extra. Egg retrieval is done under sedation or anaesthesia.
Is ICSI better than IVF?
Not for everyone. ICSI helps when the problem is with sperm. If there is no male factor, it has not been shown to improve the chance of a baby, and it just increasing the costs.
Does ICSI guarantee fertilisation or pregnancy?
No. Fertilisation can still fail, and a fertilised egg still has to grow into a healthy embryo and implant. No one can promise a pregnancy.
What is the success rate of ICSI?
It depends mainly on the woman’s age, egg and embryo quality, and sperm quality. There is no single figure for everyone. Dr. Parul gives you a real hope after go through with your tests reports.
Are babies born through ICSI healthy?
Most are. Some studies show a slightly higher rate of birth defects than after natural conception. This may be linked to the cause of male infertility rather than ICSI. Dr. Parul will discuss this with you
Do I need ICSI if my sperm count is normal?
Usually not. Standard IVF is often enough. ICSI may still be advised in some cases, such as earlier fertilisation failure or genetic testing
What if there are no sperm in the semen?
Sperm may sometimes be collected directly from the testis or epididymis by a small procedure and used for ICSI.
How much does ICSI cost in Noida?
ICSI usually adds about ₹[ADD-ON RANGE] to the cost of an IVF cycle. [CONFIRM] See the cost section above.
How long does the ICSI process take?
A fresh cycle takes about 4 to 6 weeks from the start of stimulation to the pregnancy test. The ICSI step itself happens within hours of egg retrieval, and fertilisation is checked the next morning. A frozen transfer takes a few weeks more.
Sources and further reading
For more information about infertility and fertility treatment, you can refer to these trusted medical sources:
Reviewed by Dr. Parul Agrawal, MBBS, DGO, DNB in Obstetrics & Gynecology, Fellowship in Reproductive Medicine (ICOG recognised), Reg. no. MCI 43617.