ICSI (Micro-injection)
ICSI is an advanced IVF method in which a single healthy sperm is injected directly into the egg. It is especially used for male factor infertility.
ICSI Treatment in Turkey — At a Glance
ICSI (intracytoplasmic sperm injection) is an advanced IVF laboratory technique in which a single selected sperm is injected directly into an egg. It is used above all for male-factor infertility to improve the chance of fertilisation, and is part of the IVF process.
- What it is: one sperm is injected into the egg (the difference from conventional IVF).
- Who it's for: low sperm count/motility, previous fertilisation failure, surgically retrieved (TESE) sperm.
- The process: egg retrieval → micro-injection in the lab → embryo development → transfer.
- Difference from IVF: fertilisation is done by the embryologist, not left to happen on its own.
- Is it painful? ICSI is a laboratory step — there is no extra procedure for the patient.
- Success: it improves fertilisation when indicated; outcomes depend on age and embryo quality.
- Cost: depends on your IVF plan; you receive a personalised quote after assessment.
Who is ICSI for?
ICSI may be recommended for low sperm count or motility, previous fertilization failure, or certain specific situations.
- Low sperm count/motility
- Previous low fertilization in IVF
- Surgically retrieved sperm
- Certain sperm morphology issues
ICSI and IVF
ICSI is performed as part of the IVF process; the difference is that fertilization is achieved by micro-injection in the lab.
Suitability is determined by your physician based on sperm analysis and overall assessment.
Is ICSI Always Necessary?
ICSI is recommended only when there is a medical indication; routine use for every patient does not automatically improve results.
Suitability is determined by sperm analysis and your previous fertilization history.
What Is ICSI?
ICSI (Intracytoplasmic Sperm Injection) is an advanced IVF method in which a single healthy sperm is injected directly into the egg under a microscope. This technique helps fertilization by bypassing some of the natural fertilization barriers.
ICSI is performed as part of conventional IVF; the difference is that fertilization is achieved by micro-injection in the lab.
When Is ICSI Recommended?
ICSI is preferred especially for male-factor situations: low sperm count or motility, abnormal sperm morphology, low fertilization in previous IVF cycles, or the use of surgically retrieved sperm. Suitability is determined by sperm analysis and overall assessment.
How Is ICSI Performed?
After the eggs are retrieved, the embryologist selects the most suitable sperm and injects it directly into the egg with a fine needle. Fertilized eggs are monitored as embryos, and the most suitable one is selected for transfer based on development. The procedure is carried out by an experienced embryology team.
How Does ICSI Affect Success?
ICSI assists fertilization but does not improve egg quality or guarantee embryo development. Success depends on many factors such as age, egg and sperm quality, embryo quality and the uterine environment. ICSI is a valuable tool when appropriately indicated.
ICSI and the Male Factor
The male factor is common in couples' fertility problems. ICSI can make fertilization possible even with low sperm parameters. In severe cases, sperm obtained by surgical retrieval (TESE) can also be used in ICSI.
Does Every Patient Need ICSI?
No. ICSI is recommended only when there is a medical indication; routine use for every patient does not automatically improve results. If standard sperm parameters are normal, conventional IVF may be suitable. An ethical, evidence-based approach avoids unnecessary interventions.
The Role of the Lab and Embryology Expertise
ICSI is a delicate procedure that depends on laboratory skill. Embryologist experience, culture conditions and quality control standards directly affect outcomes. This is why laboratory and team experience matter when choosing a center.
Relationship With PICSI
In some cases, the PICSI method based on selecting mature sperm may be considered before ICSI. PICSI may be considered especially for recurrent fertilization failure or certain sperm issues.
Frequently Asked Questions
Is ICSI different from conventional IVF? Yes; fertilization is achieved by injecting the sperm directly into the egg. Is ICSI risky? It is considered safe in experienced hands. Is every fertilization successful? No; the fertilization rate depends on egg and sperm quality.
You can contact us to evaluate whether ICSI is suitable for your situation.
What Is ICSI?
ICSI stands for intracytoplasmic sperm injection. Under a microscope, the embryologist selects a single healthy sperm and injects it directly into an egg with a fine needle.
In conventional IVF, an egg and thousands of sperm are placed together in a dish and fertilisation happens on its own. In ICSI, fertilisation is achieved by injecting one sperm into each egg — which markedly improves the chance of fertilisation when sperm count or motility is low.
ICSI is not a separate alternative to IVF but a technique within the laboratory stage of it. Egg retrieval, embryo development and transfer are the same as conventional IVF; only the fertilisation method differs. For background, see male infertility and IVF.
IVF vs ICSI: What's the Difference?
“What is the difference between IVF and ICSI?” is one of the most searched fertility questions. Both are part of IVF treatment; the difference is how fertilisation is achieved.
| Feature | Conventional IVF | ICSI |
|---|---|---|
| How fertilisation happens | Sperm and egg together in a dish, spontaneously | One sperm injected into the egg |
| Best suited to | Near-normal sperm parameters | Male factor, previous fertilisation failure |
| Sperm required | Enough motile sperm | Even very few sperm can suffice |
| Next steps | Embryo development and transfer | Embryo development and transfer (same) |
Your specialist decides which is appropriate from the semen analysis and history. ICSI is not needed for every couple; it is usually chosen when there is a clear indication.
Who Is ICSI For?
ICSI most often comes up in male-factor infertility, but can be recommended in other situations too.
| Situation | Why ICSI? |
|---|---|
| Low sperm count | Fertilisation is possible even with very few sperm |
| Low sperm motility | Natural fertilisation is difficult with poorly moving sperm |
| Abnormal sperm shape | A well-formed sperm is selected and injected |
| Previous fertilisation failure | ICSI is tried when conventional IVF did not fertilise |
| Surgically retrieved (TESE) sperm | When there is no sperm in the ejaculate, testicular sperm is used with ICSI |
| Frozen / few eggs | To secure fertilisation with a limited number of eggs |
Suitability is always individual. We explain how the right technique is chosen in ICSI, PICSI or standard IVF.
How ICSI Works
ICSI happens during the laboratory stage of an IVF cycle. The steps the patient experiences are the same as conventional IVF; the difference is in the lab.
Ovarian stimulation
Hormone medication helps several eggs mature (~8–12 days).
Egg retrieval
Mature eggs are collected under light sedation.
Sperm preparation
The sperm sample is prepared and the best sperm are selected.
Micro-injection
The embryologist injects one sperm into each mature egg with a fine needle.
Embryo development
Fertilised eggs are grown to the blastocyst stage (day 5).
Embryo transfer
A suitable embryo is transferred; spare embryos can be frozen.
How Is Sperm Obtained for ICSI?
Sperm for ICSI usually comes from a standard sample; when there is no sperm in the ejaculate, surgical methods are used.
- Standard sample: in most cases an ejaculate sample is enough — ICSI can use even very few sperm.
- TESE / micro-TESE: if there is no sperm in the ejaculate (azoospermia), sperm can be retrieved from the testis with a minor procedure.
- Frozen sperm: previously frozen samples can also be used in ICSI.
Which method is needed is determined by semen analysis and any further tests. For lifestyle steps that support sperm quality, see how to improve sperm count and quality.
What Affects ICSI Success?
ICSI is powerful at the fertilisation stage, but overall pregnancy success depends on more than fertilisation alone.
| Factor | Effect |
|---|---|
| Woman's age | Egg quality and number are the strongest factors in the outcome |
| Sperm quality | DNA integrity and morphology affect embryo development |
| Egg quality | A mature, healthy egg is needed for fertilisation and growth |
| Embryo quality | Good blastocysts improve the chance of implantation |
| Laboratory & embryologist | Experience and modern conditions are critical in micro-injection |
ICSI is very effective at achieving fertilisation — but “fertilisation” and “pregnancy” are not the same thing. Our aim is to optimise all of these factors for your situation.
Is ICSI Safe?
ICSI has been performed millions of times worldwide since the 1990s and its safety is well understood.
- Extensive experience: millions of healthy babies have been born through ICSI.
- No extra procedure or pain: the micro-injection is done in the laboratory.
- Genetics: because some causes of severe male factor can be genetic, additional tests may be advised.
- Process risks: the usual IVF risks (OHSS, multiple pregnancy) apply and are managed.
Any tests and possible risks relevant to you are explained before treatment begins.
What Affects the Cost of ICSI?
ICSI is usually planned as part of IVF; the cost depends on your plan. Here are the main factors:
- The stimulation protocol and medication dose
- The ICSI laboratory step and the number of mature eggs
- Any TESE / micro-TESE or other added procedures
- Whether PGT or embryo freezing is added
After ICSI: Fertilisation and Embryo Development
After micro-injection, fertilisation is checked the next day and the embryos are monitored in the laboratory over several days.
Fertilised eggs begin to divide and usually reach the blastocyst stage by day 5. During this time embryos are assessed by their rate of development and structure, which guides which embryo to transfer and which to freeze.
A well-developing, good-quality embryo improves the chance of implantation. But fertilisation alone does not mean pregnancy; embryo quality, the uterine environment and age are also decisive. Good-quality spare embryos can be frozen for later use.
Sperm DNA Damage and Advanced Selection
Sometimes sperm count and motility look normal, yet the DNA the sperm carries is damaged (fragmented), which can affect embryo development after fertilisation.
In couples with recurrent failure or miscarriage, a sperm DNA fragmentation test may be considered. Depending on the result, advanced sperm selection such as PICSI may be preferred over standard ICSI.
Which approach is appropriate is decided by your specialist from the semen analysis and history — the aim is to choose the right technique for you and avoid unnecessary add-ons.
Frequently Searched Questions
| Soru / Question | Kısa yanıt / Quick answer |
|---|---|
| What is the difference between IVF and ICSI? | In conventional IVF fertilisation happens on its own; in ICSI a single sperm is injected into the egg. ICSI is preferred especially for male factor. |
| Is ICSI more successful than IVF? | ICSI improves fertilisation when indicated, but pregnancy success depends mainly on age and embryo quality. |
| Can ICSI be done with very few sperm? | Yes — even a small number of motile sperm can be enough for ICSI. |
| What if there is no sperm in the ejaculate? | In azoospermia, sperm can be retrieved surgically (TESE/micro-TESE) and used with ICSI. |
| Are babies born from ICSI healthy? | Millions of healthy babies have been born through ICSI; genetic tests can add reassurance where needed. |
| ICSI or PICSI — which is better? | It depends on the situation; in certain cases advanced sperm-selection such as PICSI may be considered. |
| Is ICSI needed for non-male-factor couples? | Not usually; when sperm parameters are normal, routine ICSI does not automatically improve success, so it is chosen by indication. |
| How soon is fertilisation known after ICSI? | Fertilisation is checked the day after the injection, and embryos are then monitored to the blastocyst stage. |
Why Op. Dr. Ali İhsan Gönenç?
ICSI outcomes are closely tied to the right indication, a skilled embryology team and careful laboratory conditions. Here, the process is planned individually under one specialist rather than by a rotating team, so the same person who assesses you also oversees the laboratory strategy for your case.
- Single-consultant continuity and the right choice of technique
- Modern embryology laboratory at Medical Park Bahçelievler
- Transparent, pressure-free guidance
Contact us to arrange an assessment consultation.
Op. Dr. Ali İhsan Gönenç
Obstetrics & Gynecology · IVF — Medical Park Bahçelievler IVF Center
Op. Dr. Ali İhsan Gönenç is an experienced obstetrician and gynecologist focused on infertility and IVF. The medical information on this page has been reviewed by him for accuracy.
View Doctor Profile →Frequently Asked Questions
Common questions, clearly answered.
✓ Medical content reviewed by Op. Dr. Ali İhsan Gönenç · Last updated: July 2026
Yes; fertilization is achieved by injecting the sperm directly into the egg.
No, it is only recommended when medically indicated.
ICSI (intracytoplasmic sperm injection) is an advanced IVF technique in which a single healthy sperm is injected directly into an egg to achieve fertilization. It helps overcome some natural fertilization barriers.
After the eggs are retrieved, an embryologist selects the best sperm and injects it directly into the egg with a fine needle. The fertilized eggs are then monitored as they develop into embryos.
ICSI is often used for male-factor infertility such as low sperm count or motility, abnormal morphology, previous fertilization failure, or surgically retrieved sperm. Suitability is based on the semen analysis.
ICSI helps with fertilization but does not improve egg quality or guarantee pregnancy. Success depends on age, egg and sperm quality, embryo quality and the uterine environment.
ICSI is a widely used technique that is considered safe in experienced hands. The procedure is carried out carefully by the physician and embryology team.
No. Fertilization rates depend on egg and sperm quality, so not every injected egg will fertilize. Results vary from person to person.
In ICSI the sperm is selected mainly by appearance; in PICSI, mature sperm with higher DNA integrity are identified using a binding method. PICSI is considered in specific sperm-related situations.
No. ICSI is recommended only when there is a medical indication; if sperm parameters are normal, conventional IVF may be appropriate. An evidence-based approach avoids unnecessary intervention.
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