Sperm Injection

Sperm Injection
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If fertility issues have prevented you from having children, consider UW Health's team of experts at Generations fertility care. Intracytoplasmic sperm injection is just one way that we can help improve your chances of building a family.
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If you choose in vitro fertilization (IVF) treatment, your doctor may recommend an intracytoplasmic sperm injection to fertilize the egg. We often provide these two treatments together to help you get pregnant.
To fertilize an egg, a sperm must enter the egg. The head of the sperm attaches to the outside of the egg. The sperm then moves into the egg's center or cytoplasm. When sperm cannot break into the egg, intracytoplasmic sperm injection (ICSI) may help.
You can expect a fertilization success rate with ICSI of about 75 percent. This is similar to the success rate for IVF.
While the ICSI procedure provides a good success rate, it does come with some risk. An egg fertilized in this way may not develop into a viable embryo.
Your infertility specialist may recommend ICSI as part of your IVF cycle for several reasons, including:
A failed IVF cycle using conventional fertilization
Sperm obtained through surgical means
A high percentage of incorrectly shaped sperm
High rates of sperm DNA fragmentation
Your fertility team looks at every factor of your fertility to decide if ICSI can help you get pregnant.
After an egg is fertilized with ICSI, your embryologist watches the embryo grow. The healthiest embryos are chosen for the embryo transfer or can be frozen for future use.
Your fertility care team explains every step in the ICSI process. Your eggs and sperm are collected before the procedure takes place.
During the ICSI procedure, your embryologist injects a single sperm into a mature egg.
The doctor uses a fine needle with a tip slightly larger than the size of the sperm head
The embryologist gently pushes the needle through the egg's shell and into the cytoplasm in the egg’s center
The egg with the sperm sits in a culture medium where the fertilization process continues
The fertilized egg divides and becomes an embryo
The fertility team at UW Health’s Generations Fertility Care includes doctors, nurses and lab specialists who are experts in embryology, fertility and reproduction.
At Generations Fertility Clinic, our reproductive endocrinology and infertility specialists combine state-of-the art technology and compassionate, personalized care to serve couples who wish to become parents.
Donations to UW Health are managed by the University of Wisconsin Foundation, a publicly supported charitable organization under 501(c)(3) of the Internal Revenue Code.

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Before a man’s sperm can fertilize a woman’s egg, the head of the sperm must attach to the outside of the egg. Once attached, the sperm pushes through the outer layer to the inside of the egg (cytoplasm), where fertilization takes place.
Sometimes the sperm cannot penetrate the outer layer, for a variety of reasons. The egg’s outer layer may be thick or hard to penetrate or the sperm may be unable to swim. In these cases, a procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) to help fertilize the egg. During ICSI, a single sperm is injected directly into the cytoplasm the egg.
There are two ways that an egg may be fertilized by IVF: traditional and ICSI. In traditional IVF, 50,000 or more swimming sperm are placed next to the egg in a laboratory dish. Fertilization occurs when one of the sperm enters into the cytoplasm of the egg. In the ICSI process, a tiny needle, called a micropipette, is used to inject a single sperm into the center of the egg. With either traditional IVF or ICSI, once fertilization occurs, the fertilized egg (now called an embryo) grows in a laboratory for 1 to 5 days before it is transferred to the woman’s uterus (womb).
ICSI helps to overcome fertility problems, such as:
ICSI fertilizes 50% to 80% of eggs. But the following problems may occur during or after the ICSI process:
Once fertilization takes place, a couple’s chance of giving birth to a single baby, twins, or triplets is the same if they have IVF with or without ICSI.
If a woman gets pregnant naturally, there is a 1.5% to 3% chance that the baby will have a major birth defect. The chance of birth defects associated with ICSI is similar to IVF, but slightly higher than in natural conception.
The slightly higher risk of birth defects may actually be due to the infertility and not the treatments used to overcome the infertility.
Certain conditions have been associated with the use of ICSI, such as Beckwith-Wiedemann syndrome, Angelman syndrome, hypospadias, or sex chromosome abnormalities. They are thought to occur in far less than 1% of children conceived using this technique.
Some of the problems that cause infertility may be genetic. For example, male children conceived with the use of ICSI may have the same infertility issues as their fathers.

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Though the treatment has been around for more than two decades, intracytoplasmic sperm injection (ICSI) is still considered a breakthrough procedure for treating male infertility and other problems in which fertilizing an egg may be difficult. With ICSI, a single sperm is injected directly into an egg.
ICSI is used with in vitro fertilization (IVF) and is performed in more than 65 percent of IVF procedures. As a result of IVF with ICSI, more than 17,000 babies are born in the United States each year.
ICSI may be a good option if you have:
Your doctor might also suggest ICSI if you're using frozen eggs from a previous IVF cycle or if you've chosen to have your embryos undergo genetic testing before they're placed in the uterus.
The timeline for ICSI treatment usually goes something like this:
It takes about four to six weeks to complete one IVF with ICSI treatment.
You have to wait for your partner's ovaries to respond to the medication and for her eggs to mature. While taking the medication, your partner visits the doctor every two or three days for blood work and ultrasound appointments. On the day of the egg retrieval, you and your partner spend several hours at the doctor's office or clinic, having her eggs and your sperm collected.
Then three to five days later your partner comes back to have the embryos inserted inside her uterus. This visit usually lasts about one hour. Your partner takes the pregnancy test about two weeks later.
Pregnancy and live birth rates of IVF with ICSI are similar to traditional IVF without ICSI. Based on national data, the percentage of IVF cycles resulting in a live birth (meaning at least one baby is born) is about:
In the United States, the average cost for one IVF treatment is $12,400. This amount varies, depending on how much medicine you need, where you live, and whether your state mandates insurance coverage for infertility. ICSI adds about $1,500 to the tab. If your insurance policy doesn't cover IVF with ICSI, you'll probably have to pay the entire cost up front.
BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .
SART. 2013. Fertility data table. Society for Reproductive Medicine. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx [Accessed 2016]
CDC. 2014. ART cycles using donor eggs. U.S. Centers for Disease Control and Prevention. http://www.cdc.gov/art/ART2011/sect4_fig38-42.htm#f41 [Accessed 2015]
CDC. 2015. ART success rates. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/art/artdata/index.html [Accessed 2015]
UpToDate. 2016. Assisted reproductive technologies. [Accessed 2015]
Karisa Ding is a freelance health writer and editor with expertise in preconception, pregnancy, and parenting content. A mother of two, Ding finds great joy in supporting new and expectant parents by providing information they need for the life-changing journey ahead. Ding lives in San Francisco with her family.

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Today, a couple diagnosed with male factor infertility has many advanced diagnostic and reproductive technologies available that can help them achieve their goal of becoming parents, one of which is Intracytoplasmic Sperm Injection (ICSI).
Based on the striking, successful results of this procedure, IVFMD considers ICSI one of, if not the most effective, treatment option for couples facing male factor infertility. In fact, ICSI is so remarkable that most male factor treatments have been abandoned in favor of it.
The future for the ICSI process is even more promising. Researchers expect that the current fertilization rates of 85% in non-severe cases will continue to improve. As stated previously, sperm selection for the ICSI process focuses on available motile sperm. In severe cases in which motile sperm is not available, we inject non-motile sperm in TESA/TESE cases in hopes of fertilization.
In any field of medical research, success is often measured in small degrees, resulting in only those who work in laboratories to see the impact. Occasionally, a discovery comes along that is so outstanding it revolutionizes medical treatments. Such is the case with Intracytoplasmic Sperm Injection (ICSI). A Belgian physician pioneered the ICSI process in 1991 and first reported his incredible successes at the annual American Fertility Society (now known as the American Society for Reproductive Medicine) scientific conference. When a single sperm was injected directly into an egg, it virtually eliminated the limitations found with previous male factor fertility treatments, not only addressing the issues of poor sperm motility and low count, but also showing success with sperm considered less than ideal for conventional IVF procedures. Today, ICSI has been successfully used to treat men with fresh sperm collected directly from the testis and epididymis, as well as those whose sperm was previously cryopreserved.
Why might a man’s sperm not make its way to fertilize an egg?
There are many physical steps involved in the process of conceiving a child, and a variety of problems can prevent the sperm from making its journey to fertilize the egg. Sometimes the man does not produce enough sperm, the sperm can’t swim properly, or the sperm can’t penetrate the egg. Other factors that could affect a man’s fertility include infection, hormone imbalances, injury, varicoceles, and psychological stress.
What are my options if my husband cannot produce sperm?
In most cases, sperm can be retrieved from the male reproductive tract and used for fertilization.
My husband had a failed vasectomy reversal; can we still have babies?
In most cases, sperm can be retrieved from the male reproductive tract and used for fertilization.
Testicular epididymal sperm extraction (TESE) and aspiration (TESA) are procedures performed by an urologist during which minute pieces of tissue are removed from the anesthetized testes. Once the tissue sample arrives at the laboratory, the tissue is minced and observed under the microscope. If sperm are present, they can be used to fertilize eggs through Intracytoplasmic Sperm Injection (ICSI) to produce embryos. These procedures bring hope to men with vasectomies, failed vasectomy reversals, congenital absence of the vas deferens, obstruction of the epididymis, and other conditions.
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