What is ICSI and who actually needs it?

ICSI (intracytoplasmic sperm injection) means a single sperm is injected directly into each mature egg, instead of leaving many sperm to fertilise it on their own as in conventional IVF. It's clearly beneficial for male factor infertility — very low count, poor motility or abnormal shape — and when surgically retrieved sperm is used, or after earlier fertilisation failure. For couples with normal semen parameters, studies have not shown ICSI improves live-birth rates, and it costs more. It's reasonable to ask: 'Why do you recommend ICSI for us, and what happens if we choose conventional IVF?' A good clinic will explain with reference to your reports.