Intracytoplasmic sperm injection (ICSI): how it works, when it’s used and how much it costs

1. What is ICSI?

ICSI (IntraCytoplasmic Sperm Injection) is an in vitro fertilisation technique in which a sperm is microinjected directly into an egg. This is done using a specialised micro-needle that selects the best quality sperm to maximise the chances of fertilisation.

The ICSI procedure is ideal for cases where there are severe problems with the male’s semen, such as low motility or insufficient sperm concentrations, as only a minimal amount of sperm is needed to fertilise the eggs.

2. Differences between conventional IVF and IVF-ICSI

Both techniques are part of in vitro fertilisation, but ICSI and conventional IVF differ mainly in the way fertilisation is carried out:

• Conventional IVF: The sperm must pass through the barriers of the egg to fertilise it naturally.
• ICSI: A sperm is selected and injected directly into the egg using a micro-needle.

Although ICSI is more complex and technical, it allows for higher success rates in cases of severe male infertility. In addition, the cost of ICSI is usually similar to that of conventional IVF in many clinics.

3. When is ICSI performed?

ICSI is recommended in the following cases:

3.1 Azoospermia

Azoospermia refers to the absence of sperm in the semen. In these cases, ICSI allows sperm to be obtained directly from the testicle using techniques such as testicular biopsy.

3.2 Oligozoospermia

In oligozoospermia, the concentration of sperm is low. If the sperm are of acceptable quality, ICSI allows a single sperm to be introduced into each egg.

3.3 Asthenozoospermia

Asthenozoospermia is a disorder of sperm motility. In this case, ICSI facilitates fertilisation, even when the sperm do not move properly.

3.4 Teratozoospermia

This disorder involves the presence of sperm with abnormal morphologies. ICSI allows good quality sperm to be selected, even if they have morphological abnormalities.

3.5 Combination of semen abnormalities

In cases where there are multiple semen abnormalities, such as oligoasthenoteratozoospermia, ICSI is the most effective option.

3.6 Other indications

ICSI is also recommended in cases of men who have undergone a vasectomy, those with infectious diseases (such as HIV or hepatitis), or when cancer treatment (chemotherapy or radiotherapy) has been carried out and semen has been frozen beforehand.

At our centre, we always use the ICSI technique in all fertility treatments, regardless of the cause. This allows us to maximise success rates and offer optimal control over the fertilisation process, adapting to the specific characteristics of each semen sample and egg.

4. ICSI step by step: stages of the process

The ICSI process is very similar to conventional IVF, with the only difference being in the fertilisation phase. The main steps are detailed below:

1. Controlled ovarian stimulation: Hormones are administered to stimulate the production of mature eggs.
2. Ovarian puncture: The eggs are extracted through a surgical procedure under local anaesthetic.
3. Semen collection and preparation: The semen is prepared in the laboratory to select the healthiest sperm.
4. Sperm microinjection: A sperm is injected directly into the egg.
5. Embryo culture: The embryos develop under controlled conditions.
6. Embryo transfer: The best quality embryos are selected and transferred to the mother’s uterus.
7. Embryo freezing: The remaining embryos are stored for future attempts.
8. Pregnancy test: A pregnancy test is performed to verify the success of the treatment.

5. Success rates and effectiveness

The success rates of ICSI vary depending on the woman’s age and the quality of the sperm. According to the most recent statistics, the pregnancy rates for transfers using the woman’s own eggs are:

• Under 35 years old: 43.7%
• 35 to 39 years old: 35%
• 40 to 42 years old: 21.2%

These success rates may vary depending on each clinic and the individual factors of each couple.

📈 Our clinical results are above the national average, thanks to the experience of our embryologists and the quality of our donors.

Find out more about our success rates here.

6. Possible risks

The risks of ICSI are similar to those of conventional IVF and may include:

• Ovarian hyperstimulation syndrome (OHSS): An exaggerated response to hormone medication.
• Multiple pregnancies: Risk of twin or multiple pregnancies.
• Miscarriage: Approximately 20% of pregnancies achieved through ICSI may end in miscarriage.
• Ectopic pregnancy: Risk of the embryo implanting outside the uterus.

7. Price of sperm microinjection

The price of an ICSI treatment usually ranges between £3,500 and £5,500, depending on the clinic and the services included. It is important to note that this cost does not always include medication, which can cost between £1,000 and £1,200, depending on the protocol used.

8. Frequently asked questions