What ICSI is, in simple words
ICSI is not a separate treatment from IVF. It is a different way of fertilising the eggs once they are collected. Everything before and after fertilisation stays the same.
In conventional IVF, thousands of sperm are placed around each egg and one finds its own way in. In ICSI, the embryologist picks a single sperm and injects it into the egg with a very fine glass needle. This removes the need for the sperm to swim to the egg and break through its outer shell.
Who needs ICSI
ICSI is usually advised when the sperm are unlikely to fertilise the eggs on their own. Common reasons include:
- Low sperm count (oligospermia) or very poor motility
- A high proportion of abnormally shaped sperm
- Sperm taken surgically from the testis or epididymis by TESA or PESA
- Few or no eggs fertilised in an earlier IVF cycle
- Frozen sperm samples with limited numbers
- Very few eggs collected, where each egg needs the best chance
- Eggs that were frozen earlier, since their outer shell can harden
If the semen analysis is normal and there is no history of fertilisation failure, conventional IVF often works just as well. In that case the doctor may not recommend ICSI. You can read more about male factor problems on our male infertility page.
ICSI does not fix every sperm problem
ICSI helps the sperm enter the egg. It cannot correct poor sperm DNA quality or genetic causes of infertility. When these are suspected, extra tests may be suggested before treatment.
The ICSI process, step by step
The woman goes through the same steps as a standard IVF cycle. The difference lies in what happens inside the lab on the day of egg collection.
- Tests for both partnersHormone tests, AMH and a pelvic scan for the woman. A detailed semen analysis for the man, and infection screening for both.
- Ovarian stimulationDaily injections over roughly 8 to 12 days help several eggs grow. Scans check how the follicles are developing.
- Egg collectionA short procedure under light anaesthesia removes the eggs from the ovaries. You usually go home the same day.
- Sperm preparationThe man gives a fresh sample on the same morning, or a frozen or surgically retrieved sample is thawed and prepared.
- Selecting mature eggsOnly mature eggs can be injected. The embryologist checks each egg under the microscope before ICSI.
- InjectionOne sperm with good shape and movement is chosen and injected into the centre of each mature egg.
- Fertilisation checkThe next day, the embryologist checks which eggs have fertilised normally.
- Embryo culture and transferEmbryos grow for 3 to 5 days. The best one is transferred, and suitable extra embryos can be frozen.
For the full timeline of a cycle, see our IVF treatment page.
ICSI and conventional IVF compared
| Point | Conventional IVF | ICSI |
|---|---|---|
| How fertilisation happens | Sperm placed around the egg | One sperm injected into the egg |
| Sperm needed | A good number of moving sperm | Only a few healthy sperm |
| Usual reason | Tubal factor, unexplained infertility | Male factor, previous fertilisation failure |
| Steps for the woman | Same | Same |
| Lab cost | Standard | Additional ICSI charge |
What affects the result
ICSI improves the chance of fertilisation when sperm are the main problem. Fertilised eggs still need to grow into healthy embryos, and a pregnancy is never certain. Success depends mainly on the woman's age, her egg reserve, sperm quality and embryo quality.
The number of mature eggs collected also matters, because only mature eggs can be injected. After your tests, the doctor explains your realistic chances in your own situation.
Preparing for an ICSI cycle
A few weeks of preparation can help both partners. Sperm take about three months to form, so changes made early can help the sample used on collection day.
- For the man: stop smoking, limit alcohol, avoid hot baths and saunas, and keep a healthy weight.
- For the woman: start folic acid, control thyroid and blood sugar, and keep weight in a healthy range.
- For both: finish the infection screening and blood tests well before the cycle starts.
Before collection day, the man is usually asked to abstain from ejaculation for 2 to 5 days. If producing a sample on the day may be difficult, tell the doctor early. A backup sample can be frozen in advance.
If earlier semen reports showed no sperm at all, the doctor may plan a surgical retrieval before or on the day of egg collection. This avoids a cycle where eggs are collected but no sperm is available.
Risks of ICSI
The risks of the stimulation and egg collection are the same as in any IVF cycle. These include ovarian hyperstimulation syndrome (OHSS), multiple pregnancy if more than one embryo is transferred, and ectopic pregnancy.
A small number of eggs can be damaged during injection. Some male infertility causes can be genetic and may pass to a son. If your doctor suspects this, genetic testing and counselling may be advised before treatment.
ICSI cost in Delhi
An IVF cycle with ICSI at our clinic usually costs ₹1,80,000 – ₹4,06,000. If you only need the ICSI step added to a planned IVF cycle, the add-on costs ₹20,000 – ₹50,000.
The table below shows a typical itemised cycle with ICSI included in the total.
| What it covers | Cost |
|---|---|
| Consultation and diagnosisDoctor visits before treatment | ₹1,000 – ₹5,000 |
| Pre-IVF testsHormones, AMH, infection screening, semen analysis | ₹7,000 – ₹18,000 |
| Stimulation medicinesDepends on age, AMH and body weight | ₹25,000 – ₹60,000 |
| Sperm preparationWashing and selecting sperm in the lab | ₹2,000 – ₹8,000 |
| Anaesthesia for egg collectionShort anaesthesia, same-day discharge | ₹5,000 – ₹15,000 |
| IVF procedureEgg collection, fertilisation, embryo culture and fresh transfer | ₹1,20,000 – ₹2,50,000 |
| ICSILow sperm count or motility, or earlier failed fertilisation | ₹20,000 – ₹50,000 |
| Total per cycle | ₹1,80,000 – ₹4,06,000 |
Figures as of 27 October 2026. Your exact cost is given in writing after your consultation and tests.
Your final figure depends on the medicine dose, the number of scans, and whether you need extras such as blastocyst culture, embryo freezing or surgical sperm retrieval. You get a written, itemised estimate before treatment starts. For a wider comparison, see our guide to ICSI cost in India.
Coming from outside Delhi
Many couples travel to our Delhi clinic from other cities. Most early tests, including the semen analysis, can be done in your own city and reviewed on WhatsApp.
You then need to be in Delhi for the stimulation scans, egg collection and embryo transfer. The doctor plans these dates with you in advance so travel can be arranged.