Intra-cytoplasmic sperm injection (ICSI) differs from conventional in vitro fertilisation (IVF) in that the embryologist selects a singleoocyte-fertilization-a-key-step-in-the-process-of-icsi sperm to be injected directly into an egg, instead of fertilisation taking place in a dish where many sperm are placed near an egg. ICSI enables fertilisation to happen when there are very few sperm available. Your clinic may recommend ICSI if: • you have a very low sperm count • other problems with the sperm have been identified, such as poor morphology (abnormal shape) or poor motility (not moving normally) • during previous attempts at IVF there was failure of fertilisation or an unexpectedly low fertilisation rate • you need sperm to be collected surgically from the testicles or epididymis (a narrow tube inside the scrotum, where sperm are stored and matured); for example because you have had a vasectomy, you do not ejaculate sperm, or because you have extremely low sperm production • you are using frozen sperm in your treatment which is not of optimum quality • you are using embryo testing.