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Welcome to our guide to ICSI treatment: digestible, comprehensive and reviewed by medical experts. Whether you’re brand new to fertility treatment or a pro already, this guide is for you to better understand the ins and outs of IVF with ICSI treatment.
Reviewed by Dr. Taraneh Nazem
Reproductive Endocrinologist at RMA of New York
OB/GYN and expert in reproductive medicine
A few quick facts
ICSI, pronounced “ixy,” stands for intracytoplasmic sperm injection, meaning when sperm is injected directly into an egg.
It’s a popular treatment to address male factor infertility — male factor issues account for over half of couples who have problems conceiving.1
Over 20,000 children have been born as a result of ICSI treatment.2
ICSI was created in 1992.
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What is IVF with ICSI treatment?

IVF with ICSI is a type of fertility treatment for couples or individuals who seek assistance to conceive a child. In IVF with ICSI, eggs and sperm are fertilized outside of the uterus with a procedure that places one sperm into each egg to assist with fertilization, before being implanted into the person carrying the pregnancy.

What happens in IVF with ICSI treatment?

It starts the same way as in standard IVF: a female partner will go through egg retrieval, and those eggs will be fertilized in a lab. A male partner will produce a semen sample, often in a medical facility, and it will be combined with the retrieved eggs to create embryos. But, instead of leaving the egg in a dish filled with sperm to attempt fertilization, like in standard IVF, there’s a little extra work to ensure the best quality sperm reaches eggs. 

In ICSI treatment, an embryologist will wash the sperm and select one individual sperm to inject into each egg to give the egg the best possible chance to fertilize. 

Like standard IVF, IVF with ICSI takes around 4-6 weeks, depending on your medication protocol and where you are in your menstrual cycle.3

When is ICSI recommended?

ICSI can be an option if sperm count is low, doesn’t move normally (“motility”), or has an irregular shape (“morphology”) that prevents it from fertilizing an egg.4 You might also be a good candidate if you have challenging results in your fertility history, including poor fertilization, egg thawing, and PGT-A results.

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How much does IVF with ICSI cost?

Here are average costs for IVF with ICSI:

IVF Treatment process

Base cost of IVF:  
$13,000

IVF with sperm donor

ICSI:

$1,350

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Additional procedures:

$3,000

Two needles and a doctor's hands

Medication:

$2,000-$5,000

IVF Treatment process - needles, test tubes and doctor's hands

Total average cost:
$20,850

The cost depends on your clinic and the medication your doctor prescribes.

Medication

Your doctor will prescribe the protocol that they think will work best for you. If you decide to go through multiple cycles of IVF to increase your chances of pregnancy, your doctor will be able to better understand the medication protocols that work best for your body.

Depending on your situation, there may be multiple options, including or “mild” or “stimulated” IVF cycles, which use less medication and are slightly less expensive than standard IVF. Your fertility doctor will be able to tell you which option(s) will be best for you.

Unexpected fees

Because everyone’s treatment is unique, everyone’s price is unique, too. Clinics often list “ballpark” pricing because patients might need different essential procedures and medications, like embryo freezing and storage for additional embryos created, sedation during egg collection, PGT testing, and medication, which can be up to $3,000 on top of your treatment costs.

ICSI’s additional cost

ICSI generally adds $1,350 to a standard IVF cycle’s costs.

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The bottom line

ICSI, in conjunction with IVF, is a good option for people with male factor infertility or a history of poor fertilization. The cost of standard IVF with ICSI in the US is between $19,350-$22,350, including medication and all essential procedures. If you need help financing your IVF treatment, consider applying for a Gaia Plan, which will cover all your treatment costs and allow you to start treatment for as little as a protection fee.

Common questions asked about IVF with ICSI

Your fertility doctor will be able to answer your specific questions about your unique treatment plan, but there are a handful of questions that nearly every patient asks:

What are the pros and cons of IVF with ICSI?
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Pros: For couples or people with sperm quality issues, ICSI can be an effective way to fertilize eggs. It’s relatively inexpensive compared to other treatment options. 

Cons: It won’t necessarily help if you’re dealing with egg quality issues, which can make it difficult for eggs and sperm to fertilize.5 In that case, there are likely better treatment options, which your fertility doctor will tell you about. 

Can ICSI cause twins?
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Yes. ICSI, like IVF, can sometimes cause multiple births, including twins. While the studies are outdated at this point, some show that having ICSI treatment can increase your chances of having twins, even if you have a single embryo transfer, although the odds are very rare. The reason is that sometimes, as an embryo fertilizes in a lab, it can split into multiple embryos, resulting in identical twins.10 

What are the long term effects of ICSI?
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Studies show a very small number of children born with genetic and developmental defects, but that may not be a result of ICSI. If the child conceived is a boy, he might inherit his father’s sperm quality issues.9

Why do people choose IVF with ICSI vs Standard IVF?
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IVF is a good option for many people with many fertility issues, but if you or your partner has male factor fertility issues, IVF and ICSI are a good combination to consider. ICSI isn’t proven to help if you don’t have male factor issues, as it involves cleaning and selecting the best quality sperm to fertilize an egg. Your fertility doctor can answer any questions you have about your specific situation. 

Is IVF with ICSI a good option for me?

If you have signs of male factor fertility issues, ICSI can be a good option. Your fertility doctor can help you understand the options available for your specific situation and whether you need any diagnostic tests.

Depending on factors including your age, health, and fertility history, you might be eligible for a Gaia Plan to finance your ICSI and IVF treatment.

Who is IVF with ICSI most suitable for?

ICSI is a suitable option for heterosexual couples with male factor fertility issues. Learn more about other treatment options below:

Still have questions about IVF with ICSI?

If you have any other questions about IVF we haven’t answered, DM us on Instagram.

“Exploring potential male factor issues is just as important as female, but isn't anywhere near as heavily focused on as it should be.”

a newly married happy couple

Mike and Hollie

Gaia Members since 2022
Treatment: IVF with ICSI
Treatment history: 1 IVF treatment

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