ICSI Procedure Explained Step-by-Step

Struggling with infertility, especially due to male factors, can be emotionally overwhelming—but advanced treatments like ICSI offer real hope. At Isha Women’s Hospital, the best IVF center of Dombivali we understand how precious every chance at parenthood is. That’s why we specialize in cutting-edge fertility techniques like Intracytoplasmic Sperm Injection (ICSI)—a game-changer for couples facing challenges such as low sperm count, poor motility, or unexplained infertility.
But what exactly is ICSI? How does it work? And is it the right option for you?
In this blog, we take you through the ICSI journey step-by-step, from ovarian stimulation to embryo transfer, while answering common questions about success rates, safety, and post-procedure care. Whether you’re just beginning your fertility journey or explo

What Is ICSI & Who Needs It?

One of the most advanced options available today is ICSI (Intracytoplasmic Sperm Injection)—a technique that has helped thousands of couples worldwide overcome infertility challenges, especially those related to sperm quality.
Let’s break down what ICSI is, and who can benefit from this remarkable procedure.
What Is ICSI?
ICSI is a specialized form of In Vitro Fertilization (IVF) where a single sperm is directly injected into the cytoplasm of a mature egg using a microneedle under a high-powered microscope. This technique eliminates the need for sperm to swim through the female reproductive tract or penetrate the egg on their own.
Unlike conventional IVF, where thousands of sperm are placed near an egg in a petri dish hoping one will fertilize it, ICSI is a precise and controlled fertilization method that dramatically improves the chances of successful fertilization—especially in cases where sperm quality is a concern.
Key Features of ICSI:

Targeted fertilization: Only one sperm is used per egg.
Performed as part of an IVF cycle: The woman still undergoes ovarian stimulation and egg retrieval.
Microscopic precision: Requires the expertise of a skilled embryologist and advanced lab technology.
Success even with poor sperm: Offers hope in severe male infertility where natural fertilization is nearly impossible.

At Isha Women’s Hospital, our embryologists are trained in the latest micromanipulation techniques, ensuring that each step of ICSI is carried out with utmost accuracy and care.

Who Needs ICSI?

ICSI is particularly beneficial for couples where male infertility is a contributing factor or where previous IVF attempts have not resulted in fertilization. Below are the most common indications for using ICSI:
1. Male Factor Infertility
Men with:

Low sperm count (oligozoospermia)
Poor sperm motility (asthenozoospermia)
Abnormal sperm shape (teratozoospermia)

ICSI allows the selection of a single healthy-looking sperm and bypasses all barriers to natural fertilization.
2. Unexplained Infertility
Sometimes, standard tests show no obvious cause of infertility. In such cases, ICSI provides a more controlled approach to improve fertilization outcomes.
3. Previous IVF Failures
If fertilization failed or was extremely low in a prior IVF cycle, ICSI is recommended in the next cycle to ensure better results.
4. Use of Frozen Sperm or Eggs
In the cases of frozen sperm or eggs ICSI maximizes the chance of fertilization in such cases.
5. Preimplantation Genetic Testing (PGT)
When embryos are being tested for genetic abnormalities (PGT-A or PGT-M), ICSI is preferred to avoid contamination from surrounding sperm and to ensure a clean genetic profile from a single, selected sperm.
Why Understanding This Matters
Understanding when and why ICSI is used helps couples approach their fertility journey with clarity and confidence. At Isha Women’s Hospital, Dombivali, we don’t just perform procedures—we help you understand them, personalize them, and walk with you every step of the way.
Whether you’re facing male factor infertility or have experienced failed IVF cycles, ICSI could be the key to achieving your dream of parenthood.

ICSI Procedure Explained Step-by-Step | Step 1: Ovarian Stimulation

ICSI Procedure Explained Step-by-Step
Dr Chinmay Pataki, the best gynecologist & IVF specialist of Dombivali believes that every couple deserves to understand the process they are going through. If you've been advised to undergo ICSI (Intracytoplasmic Sperm Injection), it’s natural to wonder what the procedure involves.
Let’s take a closer look at the step-by-step process of ICSI, from preparation to embryo transfer.
Step 1: Ovarian Stimulation
To begin the process, the female partner is given hormonal injections that stimulate her ovaries to produce multiple eggs, increasing the chances of successful fertilization.

Daily Hormone Injections: Fertility medications like gonadotropins are used to promote the growth of multiple follicles (fluid-filled sacs containing eggs).
Monitoring: Throughout the stimulation phase, the woman undergoes regular ultrasound scans and blood tests to monitor follicle size and hormone levels.
Trigger Shot: Once the follicles reach the desired size, a final injection known as the trigger shot (usually hCG or a GnRH agonist) is given to mature the eggs, preparing them for collection.

Step 2: Egg Retrieval (Ovum Pick-Up)

Approximately 34–36 hours after the trigger shot, egg retrieval is performed.

The procedure is done under mild sedation or anesthesia, ensuring comfort and minimal discomfort.
Using ultrasound guidance, a thin needle is passed through the vaginal wall into the ovaries to collect the eggs from each follicle.
The process usually takes 20–30 minutes, and the woman can return home the same day after resting for a short while. The collected eggs are immediately transferred to the embryology lab for evaluation.

Step 3: Sperm Collection & Preparation

On the same day as the egg retrieval, the male partner provides a semen sample. In cases where sperm cannot be obtained naturally, surgical sperm retrieval (like TESA or Micro-TESE) may be performed.

Processing: The semen sample is carefully processed to remove debris, immotile sperm, and white blood cells, isolating the healthiest, most motile sperm.
Microscopic Examination: Using specialized tools, embryologists examine the sperm under a microscope to select the best one for injection.

Dr Chinmay Pataki’s Isha Women’s Hospital, uses state-of-the-art lab technology and has trained embryologists to ensure the best possible sperm selection.

Step 4: Microscopic Sperm Injection (ICSI)

This is the heart of the ICSI procedure

Each mature egg is carefully held in place under a powerful microscope.
Using a microneedle, the embryologist picks up a single healthy sperm and injects it directly into the egg’s cytoplasm.
This process bypasses all the natural barriers that sperm typically face in reaching and fertilizing the egg.

Once the injection is complete, the eggs are placed in the advanced incubators to allow for fertilization to occur. Isha women Hospital is the first and only IVF centre in Thane with the most advanced Time-lapse incubator.
Also, ICSI requires immense precision and is performed only by trained embryologists in a highly sterile, advanced embryology lab like the one at Isha Women’s Hospital.

Step 5: Fertilization & Embryo Monitoring

Around 16–18 hours after ICSI, the fertilized eggs (zygotes) are checked for their growth

Successful fertilization is indicated by the presence of two pronuclei (2PN).
These fertilized eggs are cultured for 3 to 5 days, during which they divide and develop into embryos.
Embryos are carefully graded based on cell number, symmetry, and fragmentation to determine their quality.

The best embryos are selected either for fresh embryo transfer or cryopreservation (freezing) for future use.

Step 6: Embryo Transfer

Embryo transfer is a simple, painless outpatient procedure done 3 or 5 days after fertilization.

A thin, flexible catheter is used to place one or two healthy embryos into the uterus under ultrasound guidance.
No anesthesia is required, and the woman is advised to rest briefly afterward.
Any remaining high-quality embryos can be frozen for future use.

After transfer, a pregnancy test is scheduled about 10–14 days later to confirm implantation.
During this time, hormonal support such as progesterone is prescribed to help maintain a uterine environment suitable for embryo implantation.
Every step of the ICSI procedure—right from hormone injections to embryo transfer—demands accuracy, timing, and expertise. At Isha Women’s Hospital, Dombivli, our fertility experts and embryologists work in close coordination to offer you the best chance of success.

ICSI Success Rate & Safety

One of the most common questions couples ask is: How successful is ICSI?
While outcomes can vary, the good news is that ICSI has significantly improved the chances of parenthood for many couples who otherwise had little to no hope.
ICSI Success Rates:
ICSI has a fertilization success rate of around 60–80%, meaning most mature eggs injected with sperm will fertilize normally.
The actual pregnancy rate per ICSI cycle depends on several factors:

Female partner’s age
Egg quality
Sperm health and genetic integrity
Embryo quality and uterine receptivity

In general, younger women (under 35) with good ovarian reserve have the highest success rates.
Is ICSI Safe?
Yes, ICSI is considered a safe and well-established procedure in experienced fertility centers like Isha Women’s Hospital. Babies born through ICSI are generally as healthy as those conceived naturally or through conventional IVF.
ICSI is more than a lab technique—it’s a powerful fertility solution that gives hope to couples struggling with male factor infertility, unexplained infertility, or past IVF failures. From the very first injection to the joy of a positive pregnancy test, the ICSI journey is carefully managed by your dedicated team at Isha Women’s Hospital, Dombivali.
If you or your partner are facing fertility issues, don’t lose hope. Schedule a consultation with Dr. Chinmay Pataki, the best IVF expert of Dombivali and let our expertise and care guide you to parenthood—safely, confidently, and successfully.
With the trusted guidance of Dr. Chinmay Pataki and our expert embryology team, your dream of becoming a parent is within reach.
Book your consultation today and let us help you write your success story—because every family begins with hope.

Frequently Asked Questions (FAQs)

1. How long does the ICSI procedure take?
Ans - The injection process takes a few hours, but the full cycle spans 2–3 weeks.
2. Is ICSI painful?
Ans - The only slightly painful part is egg retrieval, done under anesthesia.
3. Can ICSI improve my IVF success?
Ans - Yes, especially in cases with male factor infertility or poor previous fertilization.
4. How soon can I know if it worked?
Ans - You'll take a pregnancy test around 10–14 days after embryo transfer.
5. Are there risks with ICSI?
Ans - Risks are low, but may include fertilization failure or embryo issues in rare cases.