Intracytoplasmic Sperm Injection (ICSI) and Intracytoplasmic Morphologically-Selected Sperm Injection (IMSI) are two advanced fertility treatment methods which are used in combination with In-Vitro Fertilization (IVF). Both treatments may be helpful to couples whose fertility issues are due to the male partner having poor quality sperm, blockages in his sperm ducts, or a low sperm count. In both ICSI and IMSI, a single sperm cell is used to try and fertilize a mature egg which has been harvested from the female partner. This increases the chance of successful fertilization.

The First Step

The first stage in both the ICSI and IMSI procedures is same as the first step in IVF treatment. Ovulation-inducing drugs will be administered to the woman and several mature eggs harvested from her ovaries. Her male partner will be required to produce a sperm sample. This sperm is then used to fertilize the eggs in a laboratory, using either the ICSI or IMSI technique. The resulting embryos are then inserted into the woman's uterus, where they will (hopefully) implant and develop into a healthy baby (perhaps even more than one).


Both ICSI and IMSI are micromanipulation techniques. In ICSI, a single sperm cell is injected directly into an egg (usually, several single sperm cells are injected directly into several eggs). This gives the sperm cell a head start when it comes to fertilization. Fertility specialists recommend this technique when there are problems with a man's sperm, and this is the reason why his female partner is struggling to get pregnant.


IMSI is basically ICSI with the added "advantage" that more attention is paid to the quality of the sperm to be injected into the egg. In IMSI, the man's sperm sample is examined under a high-definition microscope and only those sperm cells which appear have "good" genetic characteristics are selected for injection into the female partner's eggs.

Practitioners of IMSI say that the use of only good quality sperm makes IMSI a more successful fertility treatment than ICSI. Some fertility doctors argue, however, that picking out good quality sperm is already part of the ICSI process, if ICSI is carried out properly. In medical trials carried out in Italy, a group of couples treated with IMSI had a 39.2 % pregnancy rate. In the same trial, in a group of couples treated with ICSI, there was a pregnancy rate of 26.5%. Fertility doctors agree that more data is needed on the "healthy baby" rate and the cost of IMSI treatment to determine whether or not it would be more effective to offer IMSI in place of ICSI.


Both ICSI and IMSI are expensive fertility treatments. It's often the case that these treatments are suggested only after more conventional methods of fertility treatment (including IVF) have been tried, but failed to produce results. The cost of IMSI is said to be twice as much as that of ICSI, which may rule out IMSI for some couples. ICSI is available in the United States (as is IMSI - but perhaps not as widely). Due to cost concerns, some couples are tempted to shop around and look at fertility clinics abroad (in South America, or Turkey, for example). Needless to say, you should carefully check out the credentials of any fertility clinic before handing over any money and certainly before you let them begin treatment.

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