< Back to the Blog
Fertility

What Is ICSI?

Clara Siegmund
Clara Siegmund

Intracytoplasmic sperm injection may be the best way to get pregnant if you’re dealing with male factor infertility. Here’s everything you need to know about this fertility procedure, and how it can help you on your journey to parenthood.

Modified On:
Published:
Jun 20, 2025
Est. Read Time:
0
abstract-shape-red-pink
Published:
Jun 18, 2025
Est. Read Time:
0

Intracytoplasmic sperm injection may be the best way to get pregnant if you’re dealing with male factor infertility. Here’s everything you need to know about this fertility procedure, and how it can help you on your journey to parenthood.

Fertility
Share to:
No items found.

Intracytoplasmic sperm injection may be the best way to get pregnant if you’re dealing with male factor infertility. Here’s everything you need to know about this fertility procedure, and how it can help you on your journey to parenthood.

Infertility can affect anyone. In fact, people with sperm are just as likely to experience fertility issues as people with eggs.

Luckily, fertility treatments can help with all different types of problems. In cases of male factor infertility, ICSI may be the key to pregnancy for you and your partner.

In this guide to ICSI, we’ll break down what ICSI is, how it works, who should consider this fertility treatment, how effective it is, and how much ICSI costs.

What is ICSI?

Intracytoplasmic sperm injection, or ICSI, is a form of assisted reproductive technology (ART). This fertility treatment method is a more specialized and targeted type of IVF. Like conventional IVF, the procedure takes place in a lab. 

With ICSI, a single sperm is injected directly into the inside of an egg, aka the cytoplasm—hence the name, intracytoplasmic sperm injection! Then, the resulting embryo is transferred to the uterus.

About half of couples faced with infertility have sperm-related issues, like low sperm count, or sperm that has a hard time swimming or breaking through the egg’s protective barrier. Since ICSI enables sperm to directly penetrate an egg, the procedure offers the possibility of getting a viable embryo despite sperm-related issues. 

In other words, ICSI is a key fertility treatment for people dealing with male factor infertility. 

Some people may elect to do ICSI (or combine it with conventional IVF), even if they don’t have any particular medical need for the procedure. But experts like the American Society for Reproductive Medicine (ASRM) don’t recommend using ICSI across the board—we’ll get into who should consider ICSI below.

>>MORE: Do People Actually Use Turkey Basters to Get Pregnant? Everything You Need to Know About IUI

How does ICSI work?

ICSI is a multi-step process, like many ART procedures. 

Here are the steps you can expect during your ICSI treatment process:

  • Producing and collecting the eggs
  • Collecting and preparing the sperm
  • Fertilization with ICSI
  • Embryo transfer

Producing and collecting the eggs

Like many fertility treatments, the ICSI process generally starts with ovarian stimulation. 

Ovarian stimulation is intended to help you produce as many eggs as possible, in order to increase your chances of successful fertilization and a successful pregnancy. To do that, you take ovulation-boosting medication that triggers egg production. Then your doctor extracts the mature eggs from the ovaries in preparation for fertilization.

Collecting and preparing the sperm

Sperm is typically collected through ejaculation, generally at your fertility clinic. 

If your situation calls for different methods, your doctor might recommend procedures like electroejaculation (EEJ) or surgical sperm extraction. Both these methods are safe, and are commonly used when conditions like spinal cord injuries or nerve problems make unassisted ejaculation impossible.

Then, the sperm is carefully prepared and analyzed (methods vary depending on your fertility needs). Only the best and most viable sperm are selected for the next step.

>>MORE: What Is Reciprocal IVF? Everything You Need to Know

Fertilization with ICSI

Once the sperm and the eggs are ready, it’s time to fertilize each egg individually using the ICSI procedure. This step is done by doctors in the fertility clinic, so you’re not directly involved.

During the ICSI procedure, special tools are used to:

  • Hold the egg in place
  • Immobilize and pick up a single sperm (a spermatozoon)
  • Insert the sperm through the outside of the egg
  • Inject the sperm directly into the inside of the egg

After the sperm is injected, each fertilized egg is monitored in the lab over the course of 1 to 5 days. During this time, your doctor checks for signs of successful fertilization and development. The goal is to get a viable embryo. 

In order to increase your chances of getting a viable embryo, your doctor fertilizes multiple eggs. But remember: one egg, one sperm—meaning each egg only comes into contact with a single sperm (that’s part of what makes ICSI different from conventional IVF).

Embryo transfer

Once your doctor determines that a viable embryo is ready, it’s time for the final step: the embryo transfer.

During the embryo transfer, the embryo is inserted into the uterus. Now, the hope is that the embryo will implant in the uterine lining and you’ll become pregnant!

For those interested in fertility preservation, you can also elect to freeze the embryo at this stage instead of doing an immediate transfer.

Is ICSI right for me?

If you and your partner are dealing with male factor infertility, ICSI may be the best fertility treatment for your needs—and the best way to get pregnant.

ICSI could be right for you if you’re facing fertility issues like:

  • Low sperm count: ICSI only needs small quantities of sperm, whereas other ART procedures (including conventional IVF and IUI) need lots of sperm.
  • Sperm motility issues: If sperm doesn’t move in the way it should, you may need ICSI to get the sperm to the egg.
  • Sperm morphology issues: Abnormally shaped sperm may not be able to penetrate an egg without extra help from a targeted procedure like ICSI.
  • Ejaculation issues: ICSI offers another way to fertilize an egg when medical factors, like blockages in the reproductive tract, make ejaculation impossible.

ICSI may also be a helpful fertility treatment option if:

  • You’ve had a vasectomy reversed
  • You’ve undergone multiple conventional IVF cycles and haven’t gotten pregnant
  • You’re using frozen eggs
  • You’re using frozen sperm

Some people also decide to do ICSI alongside conventional IVF, as a fertilization backup plan. However, if you don’t have male factor infertility issues and you aren’t using frozen eggs or sperm, current research indicates that ICSI isn’t more effective than conventional IVF. Experts recommend doing ICSI only when there’s a specific medical need for it. In other cases, conventional IVF is often sufficient.

How successful is ICSI?

Successful pregnancies with ICSI are thought to occur about 30% to 41% of the time. (For comparison, that’s about the same as IVF.) This rate can vary depending on factors like age and fertility diagnosis.

For male factor infertility, ICSI is more effective than conventional IVF, meaning the chances of having a baby in this scenario are higher with ICSI.

How much does ICSI cost?

ICSI is typically charged as an added fee in an IVF cycle. At baseline, an IVF cycle may cost over $12,000. Some data indicates that ICSI can cost around an extra $1,500 per IVF cycle in the United States, but fees may vary depending on the fertility clinic.

What is ICSI? The bottom line

ICSI is a safe and effective ART procedure that involves injecting a single sperm directly into a single egg, then transferring the resulting embryo to the uterus. 

This fertility treatment is likely the most effective way to get pregnant when facing male factor infertility. So if you’re dealing with sperm-related issues and other male factor infertility problems, ICSI may be the key to having a baby.

Your fertility care team will help you figure out if ICSI is right for you, so you can choose your treatment path and move forward on your journey to parenthood.

About the author

Clara Siegmund
Clara Siegmund is a writer, editor, and translator (French to English) from Brooklyn, New York. She has a BA in English and French Studies from Wesleyan University and an MA in Translation from the Sorbonne. She is passionate about literature, reproductive justice, and using language to make information accessible.‍

Sources

https://www.oova.life/blog/progesterone-supplementation-guide
Can I take progesterone if I'm breastfeeding?
Yes, progesterone is generally safe while breastfeeding and doesn't significantly affect milk supply. However, always discuss with your healthcare provider before starting any hormone supplementation while nursing.
https://www.oova.life/blog/progesterone-supplementation-guide
Is it safe to take progesterone throughout pregnancy?
Yes, when prescribed by your healthcare provider. Progesterone supplementation in early pregnancy is safe and can reduce miscarriage risk in women with low progesterone or a history of pregnancy loss. Most providers continue supplementation through the first trimester (weeks 10-12) when the placenta takes over.
https://www.oova.life/blog/progesterone-supplementation-guide
Can progesterone supplementation cause weight gain?
Progesterone can cause temporary water retention and bloating, which may show up as a few pounds on the scale, but it doesn't cause true fat weight gain. Most women don't experience significant weight changes from progesterone supplementation.
https://www.oova.life/blog/progesterone-supplementation-guide
Can I switch from pills to suppositories or vice versa?
Yes, but only under your doctor's guidance. The dosing and timing may need adjustment when switching between forms since they're absorbed differently. Never switch on your own, especially if you're pregnant or undergoing fertility treatment.
https://www.oova.life/blog/progesterone-supplementation-guide
Will progesterone supplementation delay my period?
Yes, progesterone keeps the uterine lining intact, so if you're not pregnant and continue taking progesterone, your period will be delayed. Once you stop taking it, your period should start within 2-10 days. If you are pregnant, progesterone helps maintain the pregnancy and you won't get a period.
https://www.oova.life/blog/progesterone-supplementation-guide
Should I take progesterone pills orally or vaginally?
For fertility and pregnancy support, vaginal progesterone is usually preferred because it delivers higher concentrations directly to the uterus. For perimenopause or general hormone balance, oral progesterone often works well and is more convenient. Your doctor will recommend the best route based on your specific needs.
https://www.oova.life/blog/progesterone-supplementation-guide
When should I start taking progesterone after ovulation?
Typically, progesterone supplementation for luteal phase support starts 2-3 days after ovulation (confirmed by LH surge or temperature rise). Your doctor will give you specific timing based on your protocol. Some women start immediately after a positive ovulation test.
https://www.oova.life/blog/progesterone-supplementation-guide
What's better: progesterone cream or pills?
Pills (oral micronized progesterone) are generally more effective and reliable than creams because absorption from creams is inconsistent. For medical conditions like fertility issues, low progesterone, or HRT, prescription pills or suppositories are strongly recommended over over-the-counter creams.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
How can I tell if I have low or high progesterone?
The only definitive way to know is through hormone testing via blood tests or at-home urine tests that measure progesterone metabolites. However, symptom patterns can provide clues: anxiety and irregular periods suggest low progesterone, while bloating and extreme fatigue suggest high progesterone.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
When during my cycle should I test progesterone levels?
Test progesterone levels during the luteal phase, typically 7 days after ovulation or around day 21 of a 28-day cycle. This is when progesterone should be at its peak, making it easier to identify if levels are too low or too high.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
What are the main differences between low and high progesterone symptoms?
Low progesterone typically causes irregular or heavy periods, anxiety, hot flashes, and sleep issues. High progesterone causes bloating, fatigue, intense breast tenderness, and depression-like mood changes. Low progesterone symptoms persist throughout your cycle, while high progesterone symptoms are most intense during the luteal phase.
https://www.oova.life/blog/low-vs-high-progesterone-symptoms
Can you have symptoms of both low and high progesterone?
Some symptoms like breast tenderness and mood changes can occur with both low and high progesterone, making it confusing. However, the timing, intensity, and accompanying symptoms differ. Hormone testing is the best way to determine which imbalance you're experiencing.
https://www.oova.life/blog/10-dpo
Can stress affect 10 DPO symptoms?
Yes, stress can worsen or mimic 10 DPO symptoms. Stress increases cortisol, which can cause cramping, fatigue, and mood changes similar to both PMS and early pregnancy. During the two-week wait, try stress-reduction techniques like gentle exercise, meditation, or spending time with loved ones.
https://www.oova.life/blog/10-dpo
Is it better to test at 10 DPO or wait?
It's better to wait until 12–14 DPO for more accurate results. Testing at 10 DPO often leads to false negatives because hCG levels may still be too low. If you absolutely can't wait, use a sensitive early detection test with first morning urine, and be prepared to retest in 2–3 days if negative.
https://www.oova.life/blog/10-dpo
What does implantation bleeding look like at 10 DPO?
Implantation bleeding at 10 DPO is typically light pink or brown, much lighter than a period, and lasts 1–2 days. It's often just spotting when you wipe or a few drops on a panty liner. However, only 15–20% of pregnant women experience implantation bleeding—most don't have any bleeding at all.
https://www.oova.life/blog/10-dpo
Why am I cramping at 10 DPO?
Cramping at 10 DPO can be caused by elevated progesterone (whether you're pregnant or not), implantation (if you're pregnant), or premenstrual cramping. Unfortunately, cramping alone can't tell you if you're pregnant since progesterone causes similar symptoms in both scenarios.
https://www.oova.life/blog/10-dpo
What are the chances of a BFP at 10 DPO?
If you're pregnant, you have about a 50–60% chance of getting a positive test at 10 DPO. This means there's a 40–50% chance of a false negative even if you conceived. Chances improve significantly by 12–14 DPO.
https://www.oova.life/blog/10-dpo
What DPO is most accurate for pregnancy testing?
14 DPO (the day of your missed period) is the most accurate time to test, with 99% accuracy. 12 DPO offers 80–90% accuracy. 10 DPO has only 50–60% accuracy. For best results, wait as long as you can—ideally until 12–14 DPO.
https://www.oova.life/blog/10-dpo
Is 10 DPO too early to test?
10 DPO is considered early for pregnancy testing. While some women get positives at 10 DPO, accuracy is only 50–60% if you're pregnant. For best results, wait until 12 DPO (80–90% accuracy) or 14 DPO/missed period (99% accuracy).
https://www.oova.life/blog/10-dpo
Can you have implantation at 10 DPO?
Yes, implantation can still occur at 10 DPO, though 84% of women have already implanted by this point. Late implantation at 10–12 DPO is normal. If implantation happens at 10 DPO, you won't get a positive pregnancy test for another 2–3 days.
https://www.oova.life/blog/10-dpo
What does a negative test at 10 DPO mean?
A negative test at 10 DPO does not mean you're not pregnant. It's very common to get negatives at 10 DPO even if you conceived. Your hCG levels may still be too low, or implantation may have occurred later. Wait until 12–14 DPO to retest for more accurate results.
https://www.oova.life/blog/10-dpo
Can you get a positive pregnancy test at 10 DPO?
Yes, but only about 50–60% of pregnant women will get a positive at 10 DPO. The other 40–50% have hCG levels that are still too low to detect. If you test negative at 10 DPO, wait 2–3 days and test again.
https://www.oova.life/blog/high-progesterone-symptoms
Can high progesterone cause weight gain?
Yes, elevated progesterone can cause temporary weight gain through water retention and bloating. This is a normal part of the luteal phase and early pregnancy.
https://www.oova.life/blog/how-to-increase-estrogen
Does stress affect estrogen levels?
Yes, chronic stress elevates cortisol, which can suppress estrogen production and disrupt hormonal balance. Stress reduction through meditation, yoga, adequate sleep, and self-care practices helps maintain optimal estrogen levels.
https://www.oova.life/blog/how-to-increase-estrogen
When should I consider medical treatment for low estrogen?
Consider medical intervention if natural methods don't improve symptoms after 3 months, if symptoms severely impact quality of life, if you're experiencing early menopause (before 40), or if you have fertility concerns. Hormone replacement therapy may be appropriate in these cases.
https://www.oova.life/blog/how-to-increase-estrogen
What are the signs that my estrogen is increasing?
Signs of rising estrogen include more regular menstrual cycles, reduced hot flashes, improved vaginal lubrication, better mood stability, increased energy, and improved skin elasticity. You may also notice reduced symptoms that originally indicated low estrogen.
https://www.oova.life/blog/how-to-increase-estrogen
Can exercise increase estrogen levels?
Yes, moderate exercise stimulates estrogen release and helps maintain hormonal balance. Aim for 150 minutes of moderate cardio weekly plus strength training twice per week. However, excessive exercise can actually lower estrogen, so balance is key.
https://www.oova.life/blog/how-to-increase-estrogen
How long does it take to increase estrogen naturally?
With consistent dietary and lifestyle changes, you may notice improvements in symptoms within 4-8 weeks. However, significant hormonal changes typically take 2-3 months. Tracking your cycle and symptoms can help you monitor progress.
https://www.oova.life/blog/how-to-increase-estrogen
What foods increase estrogen levels naturally?
Foods high in phytoestrogens can help increase estrogen naturally. The best options include flax seeds (high in lignans), soy products (tofu, tempeh, edamame), lentils, chickpeas, whole grains (oats, quinoa, brown rice), and garlic. These plant compounds mimic estrogen's effects in the body.
https://www.oova.life/blog/perimenopause
What helps relieve hot flashes quickly?
Cool environments, layered clothing, herbal teas, and medical treatments like gabapentin or HRT may help—depending on severity. Lifestyle changes like reducing caffeine and alcohol can also provide relief.
https://www.oova.life/blog/perimenopause
Are there tests to confirm perimenopause?
Yes. Tests measuring estradiol, LH, and FSH levels can indicate hormonal shifts—but diagnosis is often symptom-based since hormone levels fluctuate widely during perimenopause.
https://www.oova.life/blog/perimenopause
How do I know it's perimenopause and not something else?
A doctor may recommend hormone testing (like LH, E3G, and PdG) and track symptom timing. Diagnosis is often based on symptoms combined with age and menstrual pattern changes.
https://www.oova.life/blog/perimenopause
What's the earliest age perimenopause can start?
Some women begin experiencing symptoms as early as their mid-30s, though perimenopause typically starts between ages 38-45.
https://www.oova.life/blog/perimenopause
Does perimenopause affect mental clarity?
Yes. Brain fog and difficulty concentrating are common during hormone fluctuations in perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What happens after the last sign of perimenopause?
After your final period, you enter postmenopause. You'll need 12 consecutive months without a period to confirm menopause. Many symptoms gradually improve, though some like vaginal dryness may persist without treatment.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
When do perimenopause symptoms finally stop?
Some symptoms like brain fog improve after menopause, while others like hot flashes may continue for up to 10 years post-menopause. Vaginal symptoms often persist or worsen without treatment. Each person's timeline is different.
https://www.oova.life/blog/high-progesterone-symptoms
Is high progesterone a sign of pregnancy?
Yes, high progesterone is one of the earliest indicators of pregnancy. Progesterone levels rise significantly after conception to support the developing embryo and reach their peak during the third trimester.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Can you still get pregnant in late perimenopause?
Yes, you can still get pregnant during perimenopause as long as you're having periods, even if they're infrequent. Continue using birth control until you've gone 12 consecutive months without a period and have officially reached menopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
Do symptoms get worse before perimenopause ends?
Yes, most perimenopause symptoms intensify in the final 1-2 years before menopause. Hot flashes peak around your final period, vaginal symptoms worsen, and mood changes increase. However, brain fog typically improves in late perimenopause.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
How long does late perimenopause last?
Late perimenopause typically lasts 1-3 years before your final period. However, the exact duration varies significantly from person to person. You've reached menopause after 12 consecutive months without a period.
https://www.oova.life/blog/high-progesterone-symptoms
What are the symptoms of high progesterone?
High progesterone symptoms include fatigue, bloating, breast tenderness, weight gain, anxiety, depression, headaches, and food cravings. During pregnancy, you may also experience increased nipple sensitivity and muscle aches.
https://www.oova.life/blog/TBD-10-symptoms-and-how-to-get-relief
What are the first signs that perimenopause is ending?
The earliest signs include longer gaps between periods (60+ days), intensifying hot flashes that peak around your final period, and worsening vaginal dryness. These symptoms typically increase in late perimenopause before you reach official menopause.
https://www.oova.life/blog/high-progesterone-symptoms
When should I be concerned about high progesterone?
Consult a healthcare provider if you experience high progesterone symptoms outside your luteal phase when not pregnant, or if symptoms include severe pelvic pain, abnormal vaginal bleeding, or rapid weight gain while on hormone therapy.
https://www.oova.life/blog/high-progesterone-symptoms
How do you test progesterone levels?
Progesterone can be measured through blood tests at your doctor's office or at-home urine tests that measure PdG (a progesterone metabolite). Testing is typically done during the luteal phase, about 7 days after ovulation.

About the Oova Blog:
‍Our content is developed with a commitment to high editorial standards and reliability. We prioritize referencing reputable sources and sharing where our insights come from. The Oova Blog is intended for informational purposes only and is never a substitute for professional medical advice. Always consult a healthcare provider before making any health decisions.

Posts

Latest Articles

Progesterone Supplementation: Complete Guide to Pills, Suppositories & Creams
Hormones
Oct 23, 2025

Progesterone Supplementation: Complete Guide to Pills, Suppositories & Creams

Compare progesterone pills, suppositories, and creams. Learn about bioidentical options, effectiveness, side effects, and dosing for fertility and perimenopause. Written by a registered nurse.

Foods to Avoid During Perimenopause (And What to Eat Instead)
Perimenopause
Oct 23, 2025

Foods to Avoid During Perimenopause (And What to Eat Instead)

If you've noticed certain foods make your perimenopause symptoms worse, you're not imagining it. Learn which foods trigger hot flashes, worsen weight gain, disrupt sleep, and increase anxiety plus discover what to eat instead for symptom relief.

Perimenopause Belly Fat: Why It Happens & How to Lose It
Perimenopause
Oct 23, 2025

Perimenopause Belly Fat: Why It Happens & How to Lose It

If you've noticed your weight shifting to your stomach during perimenopause, you're not alone. Learn why perimenopause belly fat happens, how hormones affect fat distribution, and science-backed strategies that actually work to lose menopause belly.