If a patient of mine is going through IVF and experiencing low fertilisation rates or their sperm quality is poor, I may recommend Intracytoplasmic Sperm Injection (ICSI). ICSI is a technique where a single healthy sperm is identified under the microscope by an embryologist and then placed inside an egg to increase the chance of fertilisation and an embryo being created. ICSI is a highly specialised technology and embryologists train for many years perfecting the technique.
The ICSI procedure involves the egg being placed in a dish under a microscope and moved into position using a micro-manipulator. A holding pipette secures the egg and then a thin, sharp glass micropipette containing a single sperm pushes through the zona pellucida (outer egg casing) and then the oolemma (the cell membrane of the egg) to enter the centre (cytoplasm). The sperm is then gently placed in the centre of the egg.