ICSI treatment services (IVF): Intracytoplasmic sperm injection
A green graphic representing an embryo

ICSI treatment

Intracytoplasmic sperm injection (ICSI) is an advanced technique that involves injecting a single sperm into an egg. It may be used as part of the IVF process to increase the chances of successful fertilisation.

When is ICSI treatment necessary?

During the IVF process, we normally use standard insemination — the egg, which sits in a laboratory dish, is exposed to thousands of sperm. The fittest sperm will fertilise the egg and in this sense, the process is ‘natural’.

However, for a sperm to successfully fertilise an egg during IVF, it must penetrate the egg’s outer covering. This process may prove difficult for the sperm for a number of reasons, including:

  • Low sperm count
  • Poor sperm motility (the ability of the sperm to move)
  • Abnormal sperm morphology (shape)
  • Frozen sperm is used
  • Sperm from a testicular biopsy is used.

A semen analysis, the primary fertility test for males, will be performed as part of our initial fertility assessment to assess these parameters. Our semen analysis facility, based at our Box Hill clinic in Melbourne, meets the World Health Organisation’s 6th edition standards, reflecting the latest recommended criteria for semen testing. We are also one of only a few laboratories in Victoria able to offer DNA fragmentation testing of sperm.

Based on the results of your semen analysis, your fertility specialist will then inform you if ICSI is recommended to help increase the chances of a successful IVF treatment cycle. Additionally, we may recommend ICSI treatment if you have previously undergone one or more cycles of IVF, but these were unsuccessful due to poor fertilisation using the standard approach of natural insemination.

How does ICSI treatment work?

In intracytoplasmic sperm injection, a single sperm is injected directly into the centre of a mature egg. By injecting the sperm into the egg, the sperm no longer has to successfully penetrate the outer covering of the egg, making it easier for fertilisation to occur. However, it still does not guarantee successful fertilisation. This procedure requires expert technique and precision and thus is only performed by suitably experienced embryologists.


The ICSI process

Intracytoplasmic sperm injection is performed as part of the IVF treatment process. Following egg retrieval and sperm collection (via self-collection or testicular biopsy), the sperm are microscopically assessed for motility, size and shape. Based on this assessment, one sperm is selected for intracytoplasmic sperm injection.

The selected sperm is gently injected into the centre of a mature egg (we will assess the egg first to ensure it is mature). If fertilisation is successful, the resultant embryo is then grown and transferred into your uterus (this procedure is referred to as ‘embryo transfer’).

We’re committed to using advanced scientific techniques — that’s why we use egg spindle visualisation.

For ICSI procedures, we use an incredibly powerful microscope that uses polarised light. This leading technology allows us to assess whether an egg is in optimal condition for fertilisation and to identify the best position to inject the sperm into the egg. Additionally, it provides feedback if fertilisation with ICSI treatment is unsuccessful; our scientists can assess whether the egg or the sperm was responsible by assessing a structure called the ‘spindle’. This knowledge assists us in planning our approach to subsequent IVF treatment cycles.

Two additional techniques can assist in the selection of sperm for ICSI:

Intracytoplasmic Morphologically Selected Sperm Injection (IMSI)
Intracytoplasmic Morphologically Selected Sperm Injection (IMSI)

IMSI may be used if the semen analysis suggests abnormal sperm morphology (i.e. abnormal shape). This technique uses a high-powered microscope that magnifies structures over 6000 times, allowing us to visualise the sperm’s head, midpiece and tail. This enables our scientists to better identify abnormally shaped sperm and consequently choose the best sperm for the ICSI procedure.

Hyaluronic acid (HA) ICSI
Hyaluronic acid (HA) ICSI

High levels of sperm DNA fragmentation can prevent the sperm from fertilising the egg. However, we also know that sperm that can bind to a substance called hyaluronic acid have low levels of DNA fragmentation. Consequently, if semen analysis identifies that a man’s sperm has high levels of DNA fragmentation, we can use HA ICSI to help select the best sperm for the ICSI procedure.

What is the cost of ICSI treatment?

The cost of an IVF cycle with ICSI ranges between $4,375.50 to $5,056.00.* Please visit our IVF fees page for more detailed information.

*Fees correct as of 1 January 2024. Fees quoted represent out-of-pocket costs once Medicare rebate applied.

What are the success rates with ICSI treatment?

Fertility issues related to the male partner usually involves a low sperm concentration and count, poor sperm motility (movement) and/or abnormally-shaped sperm. Because of intracytoplasmic sperm injection, it is now possible to overcome these types of sperm-related issues. For some couples, the use of ICSI has resulted in pregnancy rates of up to 45%.1 However, it’s important to note that due to other factors, such as age and egg quality, success rates this high are not always possible.

More information about how ICSI treatment may improve your chances of a successful IVF treatment cycle can be found here.


  1. Palermo GD et al. Sem Reprod Med. 2009;27:191–201. ↩︎

Frequently asked questions

  • What is ICSI?

    Intracytoplasmic sperm injection (ICSI) is an insemination technique that may be incorporated into an IVF cycle. It involves injecting a single sperm directly into the centre of a mature egg. Fertility specialists may recommend ICSI to increase the chances of a successful IVF treatment cycle, particularly in instances of male infertility. They may also recommend ICSI if previous IVF cycles were unsuccessful.

  • How does ICSI treatment work?

    Following egg collection and sperm retrieval, our embryologists seek to identify the highest-quality egg and sperm for use in the ICSI procedure.

    First, they remove the support cells from around the eggs – these are the cells that nourish the egg throughout its growth and development. By doing this, they can identify the eggs that are mature and therefore, suitable for ICSI treatment. At this stage, our embryologists will also microscopically assess the motility, size and shape of the available sperm, so they can select the fittest sperm to inject into the mature egg.

    Prior to injection, our embryologists will also examine the profile of the mature egg using a powerful microscope with polarised light. Specifically, they will look to identify the egg’s spindle – where the DNA is located. Research shows that mature eggs with visible spindles result in significantly higher rates of fertilisation, embryo formation and pregnancy, and thus represent better eggs to inject. Locating the spindle also enables the embryologist to determine the best position to inject the sperm into the egg. The embryologist will avoid injecting directly into the area of the spindle during the ICSI procedure to prevent damage to this vital structure.

    Once a mature egg and sperm have been selected, the sperm is directly injected into the egg with extreme precision. This process facilitates fertilisation, as the sperm must no longer penetrate the egg’s outer cover. However, it still does not guarantee successful fertilisation.

  • Who is ICSI recommended for?

    ICSI is an advanced technique that may be recommended to increase the chances of a successful IVF cycle, particularly if male factor infertility is a contributing component. Male factor infertility refers to abnormalities of sperm quality, including their shape and movement, or lower numbers of sperm in a man’s semen (which is known as oligospermia). Your fertility specialist may also recommend ICSI if:

    • A woman has fewer eggs available for fertilisation (to increase the chance of conception)
    • Previous traditional IVF cycles were unsuccessful due to failed fertilisation
    • The sperm are obtained through surgical sperm retrieval procedures
    • Frozen or donor sperm are used
    • An embryo is undergoing PGT testing – during fertilisation, only one sperm fertilises the egg; however, nearby sperm may get stuck to the outside of the egg, which can interfere with genetic testing results.


    ICSI can increase the chances of successful fertilisation when needed. In traditional IVF, thousands of sperm are mixed with an egg in a laboratory dish, with the ‘fittest sperm’ fertilising that egg. In ICSI, we inject a single sperm into the egg, which may help to bypass obstacles related to fertilisation.

  • Are there risks associated with ICSI?

    Like all medical procedures, ICSI has potential risks and benefits. Some risks specific to ICSI, include:

    • Damage to a woman’s egg from the egg cleaning process and needle insertion – the risk of egg damage is very low1
    • Inheritance of male infertility if the child is male and ICSI was used to overcome male infertility in the setting of Y chromosome (genetic) abnormalities


    Your fertility specialist would only recommend ICSI if the potential benefits outweighed the potential risks. However, it is important to consider these risks and benefits for your individual circumstances.

    1. European Society of Human Reproduction and Embryology (ESHRE) et al. The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators. Reprod Biomed Online, 2017;35(5):494-510. doi: 10.1016/j.rbmo.2017.06.015

  • How many eggs do you need for ICSI?

    Your fertility specialist will usually recommend the transfer of a single embryo per IVF treatment cycle, and this includes ICSI treatment cycles. However, during an egg retrieval, we aim to collect 6–12 eggs because there is a chance that some eggs may not make it through to the embryo stage (we call this the IVF attrition rate).

    Ideally, several eggs will successfully fertilise and reach the embryo stage, ready for implantation. You can also safely store any embryos not implanted in your current cycle for use in future IVF cycles if necessary.

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Get in touch

For more information or to book an appointment with one of our fertility doctors, please call (03) 8080 8933 or email [email protected]. Fertility appointments can also be booked via our online booking page.

Our three Melbourne clinics are based in Box Hill, Clayton and East Melbourne and are open Monday–Friday: 8:00am–5:00pm. We welcome patients from all over Victoria, as well as those seeking care interstate or internationally. All fertility treatment requiring day surgery or lab access (e.g. egg collection, embryo transfer) will take place at our state-of-the-art treatment centre in Box Hill. Fertility consultations and IVF cycle monitoring can be arranged at all three Melbourne clinics.

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