Intracytoplasmic Sperm Injection at KIMS Cuddles, Electronic City, Bengaluru

Male factor infertility contributes to approximately half of all infertility cases, and yet it is the dimension of the fertility equation that is most consistently underinvestigated and most frequently overlooked in the early stages of assessment. For couples where sperm quality is severely impaired, where fertilisation has failed in a previous IVF cycle, or where sperm can only be obtained through surgical retrieval, conventional IVF insemination is unlikely to result in fertilisation. Intracytoplasmic sperm injection was developed specifically to address this problem.

At KIMS Cuddles at KIMS Hospitals, Electronic City, ICSI is performed by our experienced embryology team within a specialist IVF laboratory, providing couples across Electronic City, Hosur Road, Anekal, and South Bengaluru with access to this highly effective technique for overcoming male factor infertility.

What ICSI Is

Intracytoplasmic sperm injection is a laboratory technique performed as part of an IVF cycle. Rather than mixing eggs and sperm together in a dish and allowing fertilisation to occur naturally, ICSI involves selecting a single sperm and injecting it directly into the cytoplasm of a mature egg using an extremely fine glass needle under high-power magnification.

This direct injection bypasses the multiple natural barriers that sperm would normally need to overcome to fertilise an egg, including penetration of the egg's outer layers. As a result, fertilisation can occur even when sperm parameters are severely impaired, including very low sperm count, poor motility, or abnormal morphology.

When ICSI Is Indicated

ICSI is recommended in the following clinical situations:

• Severe oligospermia, where sperm count is very low
• Severe asthenospermia, where sperm motility is severely impaired
• Severe teratospermia, where the proportion of normally shaped sperm is very low
• Complete absence of sperm in the ejaculate, known as azoospermia, where sperm have been retrieved surgically through TESA or PESA
• Previous IVF cycle with failed or very poor fertilisation using conventional insemination
• Use of frozen sperm where the post-thaw sample has limited motility
• Use of surgically retrieved sperm where the number of available sperm is limited
• Preimplantation genetic testing cycles where ICSI ensures that only sperm DNA enters the egg, avoiding contamination of the genetic material with sperm from the zona pellucida

The ICSI Process

The IVF cycle that includes ICSI follows the same pathway as a standard IVF cycle in terms of ovarian stimulation, egg retrieval, embryo culture, and transfer. The difference lies entirely in the fertilisation step.

On the day of egg retrieval, mature eggs are identified and prepared for injection. The semen sample is prepared in our andrology laboratory, and individual sperm are selected for injection based on their morphology and motility under high-power microscopy. Each selected sperm is immobilised and drawn into a fine glass needle. The needle is then advanced through the zona pellucida and the egg's plasma membrane, and the sperm is deposited directly into the cytoplasm.

Fertilisation is assessed the following morning. Normally fertilised eggs, confirmed by the presence of two pronuclei, are continued in culture for five to six days until the blastocyst stage, when they are assessed for quality and either transferred or vitrified.

ICSI Success Rates

Fertilisation rates with ICSI are generally comparable to or better than those with conventional IVF insemination in standard cases, and significantly higher in cases of male factor infertility where conventional insemination would be unlikely to succeed. Overall IVF cycle success rates with ICSI depend on the same factors as any IVF cycle — primarily female age and embryo quality — but ICSI eliminates fertilisation failure as a variable where male factor is present.

ICSI and Sperm DNA

For couples who have experienced recurrent implantation failure or recurrent pregnancy loss, sperm DNA fragmentation testing may be recommended alongside ICSI. A high proportion of fragmented sperm DNA affects embryo development and implantation even when conventional semen parameters appear normal. Our andrology team performs sperm DNA fragmentation analysis and discusses the implications of results and any modifications to the treatment approach where relevant.

The Morphological Selection Techniques

In selected cases where standard ICSI has produced poor outcomes, advanced morphological sperm selection techniques including IMSI, which uses ultra-high magnification to select sperm with the most normal nuclear morphology, may be recommended. Our team discusses these additional techniques with couples for whom they may be relevant and explains the evidence for and against their use in the specific clinical context.

Safety and Outcomes of ICSI

ICSI has been used for over three decades and the outcomes for children born through ICSI are reassuring. Large follow-up studies have not identified any increased risk of major congenital abnormalities attributable to the ICSI technique itself. Where there is an increased risk of certain genetic conditions, this relates to the underlying cause of male infertility in the father rather than the technique used to achieve fertilisation.

Our team discusses the safety data around ICSI honestly and specifically, including the risk of transmitting certain Y chromosome microdeletions from father to son in cases of severe male factor infertility, so that couples can make fully informed decisions.

Why Choose KIMS Cuddles at KIMS Hospitals, Electronic City

ICSI is a highly skilled micromanipulation technique that depends entirely on the expertise and precision of the embryologist performing it. The quality of the sperm selection, the skill of the injection, and the handling of the egg during the procedure all directly affect fertilisation rates and subsequent embryo development. At KIMS Cuddles at KIMS Hospitals, Electronic City, our embryology team has the training and experience to perform ICSI consistently and reliably, with the laboratory infrastructure to support high-quality outcomes.

Book a Consultation

To discuss ICSI and whether it is the appropriate fertilisation technique for your IVF cycle, book a consultation at KIMS Cuddles at KIMS Hospitals, Electronic City online or by phone.