This method is called Intra-Cytoplasmic Sperm Injection or ICSI in English. This method, especially allowing men with sperm defects to have a baby, has started to be applied in 1992 for the first time.

This Micro-Injection method ushered a new era in men who have a very low pregnancy rate or have no chance at all with Conventional IVF.

Before that, men having a sperm count below 5 million/mL in sperm analysis or having sperms of bad quality had a very low chance of having a baby or had no chance at all. After 1992, with the application of microinjection, thousand of babies had born.

Patients who will receive ICSI and Conventional IVF pass through the same stages.

Conventional IVF and ICSI applications are the regarding the drugs that the patient use, ultrasound follow-up, egg collection and transfer processes.

The difference in ICSI is the unification of the eggs with spermatozoa with a different technique at the laboratory. In Conventional IVF, each egg is gathered together with approximately 100,000 sperms, but only one of them penetrates the outer membrane of the egg and enters inside and fertilizes it spontaneously. However, in Micro-Injection or ICSI, a single, pre-determined sperm cell is injected into each egg via needle. ICSI process is conducted with a device called micromanipulator.

• Man having extreme defects of sperm count, motility and morphology: ICSI should be applied instead of Conventional IVF if the sperm count is below 5 million/mL.
  
• Azospermia, that is to say, men ahowing no sperm in the sperm analysis: Sperm is obtained directly from the testis or epididiymis with PESA/MESA/TESE or TESA methods. Mature sperms (spermatozoa) obtained by this way, though very few, can be used for ICSI.
• Couples that could not achieve fertilization with Conventional IVF method (total fertilization failure).
  
• Couples that Pre-implantation genetic diagnosis (PGD) will be performed on their embryos.
  
• To increase the chance of pregnancy in some selected patients (couples having low chance).
  

Today ICSI is being applied to all patients receiving test tube baby application in many centres.

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