When sperm counts are very low, or the sperm does not have sufficient movement or it is abnormally shaped, fertilization may not be possible even in the test tube. In this case, the sperm is directly injected in to an egg and this procedure is called Intra Cytoplasmic Sperm Injection (ICSI). ICSI brings success rates to the same levels with standard IVF in most cases of male infertility. We also prefer ICSI in fertility preservation cases to ensure that we do not experience an unexpected fertilization failure, since most fertility preservation patients will not have time to undergo a repeat cycle (as they are undergoing medical treatments that can affect their future fertility).

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