Written by Achuta Uppu, MD. Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Intracytoplasmic Sperm Injection?
A fertility doctor, called a reproductive endocrinologist, often provides this procedure, known as ICSI. ICSI is done along with in vitro fertilization (IVF) to help fertilize an egg. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
During ICSI, a single sperm is injected directly into the cytoplasm of an egg. The cytoplasm is the inside of the egg, where fertilization takes place. After fertilization, the fertilized egg is called an embryo.
Why a doctor might recommend it
Sometimes the sperm cannot get through the outer layer of the egg. The outer layer may be thick, or the sperm may be unable to swim normally. ICSI can help when the male partner makes too few sperm for artificial insemination or IVF. It can help when a blockage in the male reproductive tract keeps sperm from getting out. It is also used when IVF has not been successful in producing a fertilized egg. It is also used when previously frozen eggs are being used.
How to prepare
ICSI is part of an IVF cycle, so these steps come first.
- The woman takes medicine by injection for 8 to 14 days to make many mature eggs at one time.
- The man gives a semen sample.
- If sperm cannot fertilize an egg without help, couples should consider genetic testing.
What happens during it
First, a needle goes through the wall of the vagina to the ovaries to take out the eggs. This step is called egg retrieval. A mild sedative and painkiller are often used. Then a tiny needle called a micropipette injects a single sperm into the center of an egg. The embryo grows in a laboratory for 1 to 5 days before it is moved to the woman's uterus. For the transfer, a provider uses a long, thin tube. It goes through the vagina into the uterus, and the embryo is injected there.
Recovery
After egg retrieval, mild to moderate pelvic and belly pain can happen. In most cases the pain goes away within a day or two. Embryo transfer is normally painless. Some women may have cramping. Some women have slight bleeding, called vaginal spotting, afterward.
Risks and side effects
ICSI fertilizes 50% to 80% of eggs. Some or all of the eggs may be damaged. An egg might not grow into an embryo even after it is injected with sperm. Boys conceived with ICSI may have the same infertility issues as the man who provided the sperm. There is a small risk of an ectopic pregnancy, which is a pregnancy outside the uterus. If you have not had an ultrasound that shows the pregnancy is in the uterus, call your doctor right away if you have vaginal spotting or lower back pain. These can be signs of a possible ectopic pregnancy. Call 911 or go to the emergency room if you have trouble breathing, chest pain or discomfort lasting two minutes or more, fainting, severe belly pain or pressure, coughing up or vomiting blood, or bleeding that will not stop.
Who performs it
Your health care provider can talk with you about the options and may send you to a fertility specialist. For IVF, a health care provider takes out the eggs and places the embryo in the uterus.
Common questions
Is ICSI the same as IVF?
No, ICSI is a step that can be done along with IVF to help fertilize the egg. In traditional IVF, 50,000 or more swimming sperm are placed next to the egg in a laboratory dish.
Does ICSI make pregnancy more likely than regular IVF?
No, the pregnancy rate is about the same with ICSI or natural fertilization in IVF.
Can ICSI affect a baby's health?
The chance of birth defects with ICSI is similar to IVF, which is slightly higher than in natural conception. This slightly higher risk may be due to infertility and not the treatments used. ASRM also says there may be a slight increased risk of changes in the sex chromosomes, but it is uncertain whether ICSI itself is the cause.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
Sources
- American Society for Reproductive Medicine - Intracytoplasmic Sperm Injection (ICSI)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development - Assisted Reproductive Technology (ART)
- American Society for Reproductive Medicine - In Vitro Fertilization (IVF): What are The Risks?
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
