Intracytoplasmic sperm injection (ICSI) was first introduced in 1992, with the first successful baby delivered in 1996 (Li et al., 1997). In 2005, ICSI was the most common form of infertility treatment used in Australia (Persson, 2005). This technology involves injecting a single sperm into the center of an ovum under a microscope. It was developed to help couples who could not use IVF due to low sperm counts or sperm motility. Usually ejaculated sperm are used, but sperm can also be removed from the epididymis or the testes (Van Steirteghem et al., 1998).
Results have been promising so far (pregnancy rates of approximately 52%), but there have been some difficulties (Simpson & Lamb, 2001). The ovum can be damaged during the procedure, and research indicates that ICSI may lead to an increased risk of genetic defect, which may be due to the fact that ICSI eliminates many of the natural barriers to conception, increasing the transmission of abnormal genes (Al-Shawaf et al., 2005). Scientists do not know how nature chooses one sperm for fertilization, and choosing one randomly may not be appropriate, though physicians usually try to pick one that appears vigorous and healthy.